Modulation of C-reactive protein expression

ABSTRACT

Compounds, compositions and methods are provided for modulating the expression of C-reactive protein. The compositions comprise oligonucleotides, targeted to nucleic acid encoding C-reactive protein. Methods of using these compounds for modulation of C-reactive protein expression and for diagnosis and treatment of disease associated with expression of C-reactive protein are provided.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Nos. 60/475,272, filed Jun. 2, 2003, and 60/540,042, filed Jan. 28, 2004.

BACKGROUND OF THE INVENTION

The present invention provides compositions and methods for modulating the expression of C-reactive protein.

C-reactive protein (also known as CRP and PTX1) is an essential human acute-phase reactant produced in the liver in response to a variety of inflammatory cytokines. The protein, first identified in 1930, is highly conserved and considered to be an early indicator of infectious or inflammatory conditions. Plasma C-reactive protein levels increase 1,000-fold in response to infection, ischemia, trauma, burns, and inflammatory conditions. Since the biological half-life of C-reactive protein is not influenced by age, liver or kidney function or pharmacotherapy, it is a reliable biochemical marker for tissue destruction, necrosis and inflammation and its measurement is widely used to monitor various inflammatory states, angina pectoris, vascular insults, end-stage renal disease, rheumatoid arthritis, obesity and atherosclerosis (Arici and Walls, Kidney Int., 2001, 59, 407-414; Gabay and Kushner, N. Engl. J. Med., 1999, 340, 448-454; Highton et al., J. Rheumatol., 1985, 12, 871-875; Hulthe et al., Clin Sci (Colch), 2001, 100, 371-378; Lagrand et al., Circulation, 1999, 100, 6+96-102; Morrow and Ridker, Med. Clin. North Am., 2000, 84, 149-161, ix; Szalai et al., Immunol Res, 1997, 16, 127-136; Westhuyzen and Healy, Ann. Clin. Lab. Sci., 2000, 30, 133-143; Yudkin et al., Atherosclerosis, 2000, 148, 209-214).

Improved methods of quantifying C-reactive protein have led to increased application to clinical medicine including diagnoses of urinary tract infections (Arici and Walls, 2001, cited above), meningitis (Ruuskanen et al., J. Pediatr., 1985, 107, 97-100), neonatal sepsis, erythropoietin resistance (Barany, Nephrol. Dial. Transplant., 2001, 16, 224-227) and occult bacteremia, conditions in which C-reactive protein is usually elevated.

Structurally, C-reactive protein is a member of the pentraxin family of proteins, which are characterized by a cyclic pentameric structure and radial symmetry. The five identical 24-kDa protomers consist of 206 amino acids, and are noncovalently linked (Lei et al., J. Biol. Chem., 1985, 260, 13377-13383; Szalai et al., 1997, cited above). The genomic DNA sequence for human C-reactive protein has been reported by Lei et al. 1985, cited above, as have mutant forms of the protein (International Patent Publication No. WO 96/06624) and methods to deliver materials into cells using the mutant protein as a carrier (International Patent Publication No. WO 00/11207). Polypeptides corresponding to amino acids 174-185 of C-reactive protein having immunomodulatory activity are disclosed and claimed U.S. Pat. No. 5,783,179. Peptides corresponding to positions 62-71 of human C-reactive protein have also been studied for their ability to inhibit the activity of human leukocyte elastase and/or cathepsin G for the treatment of inflammatory conditions and these are disclosed in International Patent Publication No. WO 99/00418.

C-reactive protein binds to a broad range of cellular substances such as phosphocholine, fibronectin, chromatin, histones, and ribonucleoprotein in a calcium-dependent manner (Szalai et al., 1997, cited above). It is a ligand for specific receptors on phagocytic leukocytes, mediates activation reactions on monocytes and macrophages, and activates complement (Szalai et al., 1997, cited above).

The function of C-reactive protein is related to its role in the innate immune system. Similar to immunoglobulin(Ig) G, it activates complement, binds to Fc receptors and acts as an opsonin for various pathogens. Interaction of C-reactive protein with Fc receptors leads to the generation of proinflammatory cytokines that enhance the inflammatory response. Unlike IgG, which specifically recognizes distinct antigenic epitopes, C-reactive protein recognizes altered self and foreign molecules based on pattern recognition. C-reactive protein is therefore thought to act as a surveillance molecule for altered self and certain pathogens. This recognition provides early defense and leads to a proinflammatory signal and activation of the humoral, adaptive immune system. Thus, the C-reactive protein molecule has both a recognition function and an effector function.

The pharmacological modulation of C-reactive protein activity and/or its expression is therefore an appropriate point of therapeutic intervention in pathological conditions.

Strategies aimed at modulating C-reactive protein function by targeting protein levels have involved the use of antibodies, peptides and molecules that inhibit HMG-CoA reductase.

In a recent trial, it was demonstrated that lovastatin, an inhibitor of the enzyme HMG-CoA reductase, is an effective agent in reducing the risk of acute coronary events in participants with elevated C-reactive protein levels but no hyperlipidemia; the use of lovastatin resulted in a 14.8 percent reduction in median C-reactive protein levels after one year whereas no change was observed in the placebo group (Ridker et al., N. Engl. J. Med., 2001, 344, 1959-1965). Another statin, cerivastatin, has also been demonstrated to lower C-reactive protein levels in patients with hypercholesterolemia (Ridker et al., Circulation, 2001, 103, 1191-1193.).

However, there are currently no known therapeutic agents that effectively inhibit C-reactive protein levels and function. Consequently, there remains a long felt need for agents capable of effectively and selectively inhibiting C-reactive protein.

SUMMARY OF THE INVENTION

The present invention provides compositions and methods for modulating C-reactive protein expression.

The present invention is directed to compounds, especially nucleic acid and nucleic acid-like oligomers, which are targeted to a nucleic acid encoding C-reactive protein, and which modulate the expression of C-reactive protein. In particular, this invention relates to compounds, particularly oligonucleotide compounds, which, in preferred embodiments, hybridize with nucleic acid molecules encoding C-reactive protein. Such compounds are shown herein to modulate the expression of C-reactive protein.

Antisense technology is emerging as an effective means for reducing the expression of specific gene products and is uniquely useful in a number of therapeutic, diagnostic, and research applications for the modulation of C-reactive protein expression.

Pharmaceutical and other compositions comprising the compounds of the invention are also provided. Further provided are methods of screening for modulators of C-reactive protein and methods of modulating the expression of C-reactive protein in cells, tissues or animals comprising contacting said cells, tissues or animals with one or more of the compounds or compositions of the invention. In these methods, the cells or tissues may be contacted in vivo. Alternatively, the cells or tissues may be contacted ex vivo.

Methods of treating an animal, particularly a human, suspected of having or being prone to a disease or condition associated with expression of C-reactive protein are also set forth herein. Such methods comprise administering a therapeutically or prophylactically effective amount of one or more of the compounds or compositions of the invention to the person in need of treatment.

In one aspect, the invention provides the use of a compound or composition of the invention in the manufacture of a medicament for the treatment of any and all conditions disclosed herein.

DETAILED DESCRIPTION OF THE INVENTION

A. Overview of the Invention

The present invention employs compounds, preferably oligonucleotides and similar species for use in modulating the function or effect of nucleic acid molecules encoding C-reactive protein. This is accomplished by providing oligonucleotides that specifically hybridize with one or more nucleic acid molecules encoding C-reactive protein. As used herein, the terms “target nucleic acid” and “nucleic acid molecule encoding C-reactive protein” have been used for convenience to encompass DNA encoding C-reactive protein, RNA (including pre-mRNA and mRNA or portions thereof) transcribed from such DNA, and also cDNA derived from such RNA. The hybridization of a compound of this invention with its target nucleic acid is generally referred to as “antisense”. Consequently, the preferred mechanism believed to be included in the practice of some preferred embodiments of the invention is referred to herein as “antisense inhibition.” Such antisense inhibition is typically based upon hydrogen bonding-based hybridization of oligonucleotide strands or segments such that at least one strand or segment is cleaved, degraded, or otherwise rendered inoperable. In this regard, it is presently preferred to target specific nucleic acid molecules and their functions for such antisense inhibition.

The functions of DNA to be interfered with can include replication and transcription. Replication and transcription, for example, can be from an endogenous cellular template, a vector, a plasmid construct or otherwise. The functions of RNA to be interfered with can include functions such as translocation of the RNA to a site of protein translation, translocation of the RNA to sites within the cell which are distant from the site of RNA synthesis, translation of protein from the RNA, splicing of the RNA to yield one or more RNA species, and catalytic activity or complex formation involving the RNA which may be engaged in or facilitated by the RNA. One preferred result of such interference with target nucleic acid function is modulation of the expression of C-reactive protein. In the context of the present invention, “modulation” and “modulation of expression” mean either an increase (stimulation) or a decrease (inhibition) in the amount or levels of a nucleic acid molecule encoding the gene, e.g., DNA or RNA. Inhibition is often the preferred form of modulation of expression and mRNA is often a preferred target nucleic acid.

In the context of this invention, “hybridization” means the pairing of complementary strands of oligomeric compounds. In the present invention, the preferred mechanism of pairing involves hydrogen bonding, which may be Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding, between complementary nucleoside or nucleotide bases (nucleobases) of the strands of oligomeric compounds. For example, adenine and thymine are complementary nucleobases that pair through the formation of hydrogen bonds. Hybridization can occur under varying circumstances.

An antisense compound is specifically hybridizable when binding of the compound to the target nucleic acid interferes with the normal function of the target nucleic acid to cause a loss of activity, and there is a sufficient degree of complementarity to avoid non-specific binding of the antisense compound to non-target nucleic acid sequences under conditions in which specific binding is desired, i.e., under physiological conditions in the case of in vivo assays or therapeutic treatment, and under conditions in which assays are performed in the case of in vitro assays.

In the present invention the phrase “stringent hybridization conditions” or “stringent conditions” refers to conditions under which a compound of the invention will hybridize to its target sequence, but to a minimal number of other sequences. Stringent conditions are sequence-dependent and will be different in different circumstances and in the context of this invention, “stringent conditions” under which oligomeric compounds hybridize to a target sequence are determined by the nature and composition of the oligomeric compounds and the assays in which they are being investigated.

“Complementary,” as used herein, refers to the capacity for precise pairing between two nucleobases of an oligomeric compound. For example, if a nucleobase at a certain position of an oligonucleotide (an oligomeric compound), is capable of hydrogen bonding with a nucleobase at a certain position of a target nucleic acid, said target nucleic acid being a DNA, RNA, or oligonucleotide molecule, then the position of hydrogen bonding between the oligonucleotide and the target nucleic acid is considered to be a complementary position. The oligonucleotide and the further DNA, RNA, or oligonucleotide molecule are complementary to each other when a sufficient number of complementary positions in each molecule are occupied by nucleobases that can hydrogen bond with each other. Thus, “specifically hybridizable” and “complementary” are terms that are used to indicate a sufficient degree of precise pairing or complementarity over a sufficient number of nucleobases such that stable and specific binding occurs between the oligonucleotide and a target nucleic acid.

It is understood in the art that the sequence of an antisense compound can be, but need not be, 100% complementary to that of its target nucleic acid to be specifically hybridizable. Moreover, an oligonucleotide may hybridize over one or more segments such that intervening or adjacent segments are not involved in the hybridization event (e.g., a loop structure or hairpin structure). It is preferred that the antisense compounds of the present invention comprise at least 70%, or at least 75%, or at least 80%, or at least 85% sequence complementarity to a target region within the target nucleic acid, more preferably that they comprise at least 90% sequence complementarity and even more preferably comprise at least 95% or at least 99% sequence complementarity to the target region within the target nucleic acid sequence to which they are targeted. For example, an antisense compound in which 18 of 20 nucleobases of the antisense compound are complementary to a target region, and would therefore specifically hybridize, would represent 90 percent complementarity. In this example, the remaining noncomplementary nucleobases may be clustered or interspersed with complementary nucleobases and need not be contiguous to each other or to complementary nucleobases. As such, an antisense compound which is 18 nucleobases in length having 4 (four) noncomplementary nucleobases which are flanked by two regions of complete complementarity with the target nucleic acid would have 77.8% overall complementarity with the target nucleic acid and would thus fall within the scope of the present invention. Percent complementarity of an antisense compound with a region of a target nucleic acid can be determined routinely using BLAST programs (basic local alignment search tools) and PowerBLAST programs known in the art (Altschul et al., J. Mol. Biol., 1990, 215, 403-410; Zhang and Madden, Genome Res., 1997, 7, 649-656).

Percent homology, sequence identity or complementarity, can be determined by, for example, the Gap program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, Madison Wis.), using default settings, which uses the algorithm of Smith and Waterman (Adv. Appl. Math., 1981, 2, 482-489). In some embodiments, homology, sequence identity or complementarity, between the oligomeric and target is between about 50% to about 60%. In some embodiments, homology, sequence identity or complementarity, is between about 60% to about 70%. In some embodiments, homology, sequence identity or complementarity, is between about 70% and about 80%. In further embodiments, homology, sequence identity or complementarity, is between about 80% and about 90%. In further embodiments, homology, sequence identity or complementarity, is about 90%, about 92%, about 94%, about 95%, about 96%, about 97%, about 98%, about 99%, or about 100%.

B. Compounds of the Invention

According to the present invention, compounds include antisense oligomeric compounds, antisense oligonucleotides, siRNAs, external guide sequence (EGS) oligonucleotides, alternate splicers and other short oligomeric compounds that hybridize to at least a portion of the target nucleic acid. As such, these compounds may be introduced in the form of single-stranded, double-stranded, circular or hairpin oligomeric compounds and may contain structural elements such as internal or terminal bulges or loops. Once introduced to a system, the compounds of the invention may elicit the action of one or more enzymes or structural proteins to effect modification of the target nucleic acid.

One non-limiting example of such an enzyme is RNAse H, a cellular endonuclease which cleaves the RNA strand of an RNA:DNA duplex. It is known in the art that single-stranded antisense compounds that are “DNA-like” elicit RNAse H. Activation of RNase H, therefore, results in cleavage of the RNA target, thereby greatly enhancing the efficiency of oligonucleotide-mediated inhibition of gene expression. Similar roles have been postulated for other ribonucleases such as those in the RNase III and ribonuclease L family of enzymes.

While one form of antisense compound is a single-stranded antisense oligonucleotide, in many species the introduction of double-stranded structures, such as double-stranded RNA (dsRNA) molecules, induces potent and specific antisense-mediated reduction of the function of a gene or its associated gene products. This phenomenon occurs in both plants and animals and is believed to have an evolutionary connection to viral defense and transposon silencing.

The first evidence that dsRNA could lead to gene silencing in animals came in 1995 from work in the nematode, Caenorhabditis elegans (Guo and Kempheus, Cell, 1995, 81, 611-620). The primary interference effects of dsRNA are posttranscriptional (Montgomery et al., Proc. Natl. Acad. Sci. USA, 1998, 95, 15502-15507). The posttranscriptional antisense mechanism defined in Caenorhabditis elegans resulting from exposure to double-stranded RNA (dsRNA) has since been designated RNA interference (RNAi). This term has been generalized to mean antisense-mediated gene silencing involving the introduction of dsRNA leading to the sequence-specific reduction of endogenous targeted mRNA levels (Fire et al., Nature, 1998, 391, 806-811). Recently, the single-stranded RNA oligomers of antisense polarity of the dsRNAs have been reported to be the potent inducers of RNAi (Tijsterman et al., Science, 2002, 295, 694-697).

In the context of this invention, the term “oligomeric compound” refers to a polymer or oligomer comprising a plurality of monomeric units. In the context of this invention, the term “oligonucleotide” refers to an oligomer or polymer of ribonucleic acid (RNA) or deoxyribonucleic acid (DNA) or mimetics, chimeras, analogs and homologs thereof. This term includes oligonucleotides composed of naturally occurring nucleobases, sugars and covalent internucleoside (backbone) linkages as well as oligonucleotides having non-naturally occurring portions which function similarly. Such modified or substituted oligonucleotides are often preferred over native forms because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for a target nucleic acid and increased stability in the presence of nucleases.

The oligonucleotides of the present invention also include modified oligonucleotides in which a different base is present at one or more of the nucleotide positions in the oligonucleotide. For example, if the first nucleotide is an adenosine, modified oligonucleotides may be produced which contain thymidine, guanosine or cytidine at this position. This may be done at any of the positions of the oligonucleotide. These oligonucleotides are then tested using the methods described herein to determine their ability to inhibit expression of C-reactive protein mRNA.

While oligonucleotides are a preferred form of the compounds of this invention, the present invention comprehends other families of compounds as well, including but not limited to oligonucleotide analogs and mimetics such as those described herein.

The compounds in accordance with this invention comprise from about 8 to about 80 nucleobases (i.e. from about 8 to about 80 linked nucleosides). One of ordinary skill in the art will appreciate that the invention embodies compounds of 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, or 80 nucleobases in length.

In one embodiment, the compounds of the invention are 12 to 50 nucleobases in length. One having ordinary skill in the art will appreciate that this embodies compounds of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50 nucleobases in length.

In another embodiment, the compounds of the invention are 15 to 30 nucleobases in length. One having ordinary skill in the art will appreciate that this embodies compounds of 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleobases in length.

In another embodiment, the compounds of the invention are oligonucleotides from about 12 to about 50 nucleobases. Further embodiments are those comprising from about 15 to about 30 nucleobases.

In another embodiment, the antisense compounds comprise at least 8 contiguous nucleobases of an antisense compound disclosed herein.

Antisense compounds 8-80 nucleobases in length comprising a stretch of at least eight (8) consecutive nucleobases selected from within the illustrative antisense compounds are considered to be suitable antisense compounds as well.

Exemplary antisense compounds include oligonucleotide sequences that comprise at least the 8 consecutive nucleobases from the 5′-terminus of one of the illustrative preferred antisense compounds (the remaining nucleobases being a consecutive stretch of the same oligonucleotide beginning immediately upstream of the 5′-terminus of the antisense compound which is specifically hybridizable to the target nucleic acid and continuing until the oligonucleotide contains about 8 to about 80 nucleobases). Similarly preferred antisense compounds are represented by oligonucleotide sequences that comprise at least the 8 consecutive nucleobases from the 3′-terminus of one of the illustrative preferred antisense compounds (the remaining nucleobases being a consecutive stretch of the same oligonucleotide beginning immediately downstream of the 3′-terminus of the antisense compound which is specifically hybridizable to the target nucleic acid and continuing until the oligonucleotide contains about 8 to about 80 nucleobases). Exemplary compounds of this invention may be found identified in the Examples and listed in Tables 1, 2 and 3. One having skill in the art armed with the preferred antisense compounds illustrated herein will be able, without undue experimentation, to identify further preferred antisense compounds.

C. Targets of the Invention

“Targeting” an antisense compound to a particular nucleic acid molecule, in the context of this invention, can be a multistep process. The process usually begins with the identification of a target nucleic acid whose function is to be modulated. This target nucleic acid may be, for example, a cellular gene (or mRNA transcribed from the gene) whose expression is associated with a particular disorder or disease state, or a nucleic acid molecule from an infectious agent. In the present invention, the target nucleic acid encodes C-reactive protein.

The targeting process usually also includes determination of at least one target region, segment, or site within the target nucleic acid for the antisense interaction to occur such that the desired effect, e.g., modulation of expression, will result. Within the context of the present invention, the term “region” is defined as a portion of the target nucleic acid having at least one identifiable structure, function, or characteristic. Within regions of target nucleic acids are segments. “Segments” are defined as smaller or sub-portions of regions within a target nucleic acid. “Sites,” as used in the present invention, are defined as positions within a target nucleic acid.

Since, as is known in the art, the translation initiation codon is typically 5′-AUG (in transcribed mRNA molecules; 5′-ATG in the corresponding DNA molecule), the translation initiation codon is also referred to as the “AUG codon,” the “start codon” or the “AUG start codon”. A minority of genes, having translation initiation codons with the RNA sequence 5′-GUG, 5′-UUG or 5′-CUG, and 5′-AUA, 5′-ACG and 5′-CUG have been shown to function in vivo. Thus, the terms “translation initiation codon” and “start codon” can encompass many codon sequences, even though the initiator amino acid in each instance is typically methionine (in eukaryotes) or formylmethionine (in prokaryotes). It is also known in the art that eukaryotic and prokaryotic genes may have two or more alternative start codons, any one of which may be preferentially utilized for translation initiation in a particular cell type or tissue, or under a particular set of conditions. In the context of the invention, “start codon” and “translation initiation codon” refer to the codon or codons that are used in vivo to initiate translation of an mRNA transcribed from a gene encoding C-reactive protein, regardless of the sequence(s) of such codons. It is also known in the art that a translation termination codon (or “stop codon”) of a gene may have one of three sequences, i.e., 5′-UAA, 5′-UAG and 5′-UGA (the corresponding DNA sequences are 5′-TAA, 5′-TAG and 5′-TGA, respectively).

The terms “start codon region” and “translation initiation codon region” refer to a portion of such an mRNA or gene that encompasses from about 25 to about 50 contiguous nucleotides in either direction (i.e., 5′ or 3′) from a translation initiation codon. Similarly, the terms “stop codon region” and “translation termination codon region” refer to a portion of such an mRNA or gene that encompasses from about 25 to about 50 contiguous nucleotides in either direction (i.e., 5′ or 3′) from a translation termination codon. Consequently, the “start codon region” (or “translation initiation codon region”) and the “stop codon region” (or “translation termination codon region”) are all regions of a molecule encoding C-reactive protein that may be targeted effectively with the antisense compounds of the present invention.

The open reading frame (ORF) or “coding region,” which is known in the art to refer to the region between the translation initiation codon and the translation termination codon, is also a region of the molecule encoding C-reactive protein that may be targeted effectively. Within the context of the present invention, a preferred region is the intragenic region encompassing the translation initiation or termination codon of the open reading frame (ORF) of a gene.

Other target regions of molecules encoding C-reactive protein include the 5′ untranslated region (5′ UTR), known in the art to refer to the portion of an mRNA in the 5′ direction from the translation initiation codon, and thus including nucleotides between the 5′ cap site and the translation initiation codon of an mRNA (or corresponding nucleotides on the gene), and the 3′ untranslated region (3′ UTR), known in the art to refer to the portion of an mRNA in the 3′ direction from the translation termination codon, and thus including nucleotides between the translation termination codon and 3′ end of an mRNA (or corresponding nucleotides on the gene). The 5′ cap site of an mRNA comprises an N7-methylated guanosine residue joined to the 5′-most residue of the mRNA via a 5′-5′ triphosphate linkage. The 5′ cap region of an mRNA is considered to include the 5′ cap structure itself as well as the first 50 nucleotides adjacent to the cap site. It is also preferred to target the 5′ cap region of a molecule encoding C-reactive protein.

Accordingly, the present invention provides antisense compounds that target a portion of nucleotides 1-2480 as set forth in SEQ ID NO: 4. In another embodiment, the antisense compounds target at least an 8 nucleobase portion of nucleotides 1-570, comprising the 5′ UTR as set forth in SEQ ID NO: 4. In another embodiment the antisense compounds target at least an 8 nucleobase portion of nucleotides 1183-2480 comprising the 3′ UTR as set forth in SEQ ID NO: 4. In another embodiment, the antisense compounds target at least an 8 nucleobase portion of nucleotides 571-1182 comprising the coding region as set forth in SEQ ID NO: 4. In still other embodiments, the antisense compounds target at least an 8 nucleobase portion of a “preferred target segment” (as defined herein) as set forth in Table 4.

Although some eukaryotic mRNA transcripts are directly translated, many contain one or more regions, known as “introns,” which are excised from a transcript before it is translated. The remaining (and therefore translated) regions are known as “exons” and are spliced together to form a continuous mRNA sequence, resulting in exon-exon junctions at the sites where exons are joined. Targeting exon-exon junctions can be useful in situations where the overproduction of a normal splice product is implicated in disease, or where the overproduction of an aberrant splice product is implicated in disease. Targeting splice sites, i.e., intron-exon junctions or exon-intron junctions, may also be particularly useful in situations where aberrant splicing is implicated in disease, or where an overproduction of a particular splice product is implicated in disease. Aberrant fusion junctions due to rearrangements or deletions are also preferred target sites. mRNA transcripts produced via the process of splicing of two (or more) mRNAs from different gene sources, known as “fusion transcripts, are also suitable target sites. Introns can be effectively targeted using antisense compounds targeted to, for example, DNA or pre-mRNA.

Alternative RNA transcripts can be produced from the same genomic region of DNA. These alternative transcripts are generally known as “variants”. More specifically, “pre-mRNA variants” are transcripts produced from the same genomic DNA that differ from other transcripts produced from the same genomic DNA in either their start or stop position and contain both intronic and exonic sequence.

Upon excision of one or more exon or intron regions, or portions thereof during splicing, pre-mRNA variants produce smaller “mRNA variants”. Consequently, mRNA variants are processed pre-mRNA variants and each unique pre-mRNA variant must always produce a unique mRNA variant as a result of splicing. These mRNA variants are also known as “alternative splice variants”. If no splicing of the pre-mRNA variant occurs then the pre-mRNA variant is identical to the mRNA variant.

Variants can be produced through the use of alternative signals to start or stop transcription. Pre-mRNAs and mRNAs can possess more than one start codon or stop codon. Variants that originate from a pre-mRNA or mRNA that use alternative start codons are known as “alternative start variants” of that pre-mRNA or mRNA. Those transcripts that use an alternative stop codon are known as “alternative stop variants” of that pre-mRNA or mRNA. One specific type of alternative stop variant is the “polyA variant” in which the multiple transcripts produced result from the alternative selection of one of the “polyA stop signals” by the transcription machinery, thereby producing transcripts that terminate at unique polyA sites. Within the context of the invention, the types of variants described herein are also preferred target nucleic acids.

The locations on the target C-reactive protein nucleic acid to which the preferred antisense compounds hybridize are hereinbelow referred to as “preferred target segments.” As used herein the term “preferred target segment” is defined as at least an 8-nucleobase portion of a target region of a molecule encoding C-reactive protein to which an active antisense compound is targeted. While not wishing to be bound by theory, it is presently believed that these target segments represent portions of the target nucleic acid that are accessible for hybridization.

While the specific sequences of certain preferred C-reactive protein target segments are set forth herein, one of skill in the art will recognize that these serve to illustrate and describe particular embodiments within the scope of the present invention. Additional preferred target segments may be identified by one having ordinary skill in view of this specification.

Target segments 8-80 nucleobases in length comprising a stretch of at least eight (8) consecutive nucleobases selected from within the illustrative preferred target segments of C-reactive protein are considered to be suitable for targeting as well.

Target segments can include DNA or RNA sequences that comprise at least the 8 consecutive nucleobases from the 5′-terminus of one of the illustrative preferred target segments (the remaining nucleobases being a consecutive stretch of the same DNA or RNA beginning immediately upstream of the 5′-terminus of the target segment and continuing until the DNA or RNA contains about 8 to about 80 nucleobases). Similarly preferred target segments are represented by DNA or RNA sequences that comprise at least the 8 consecutive nucleobases from the 3′-terminus of one of the illustrative preferred target segments (the remaining nucleobases being a consecutive stretch of the same DNA or RNA beginning immediately downstream of the 3′-terminus of the target segment and continuing until the DNA or RNA contains about 8 to about 80 nucleobases). One having skill in the art armed with the preferred target segments illustrated herein will be able, without undue experimentation, to identify further preferred target segments.

Once one or more target regions, segments or sites have been identified, antisense compounds are chosen which are sufficiently complementary to the target, i.e., hybridize sufficiently well and with sufficient specificity, to give the desired effect.

In one embodiment, the oligomeric antisense compounds can be targeted to regions of a target nucleobase sequence, such as those disclosed herein. All regions of a nucleobase sequence to which an oligomeric antisense compound can be targeted, wherein the regions are greater than or equal to 8 and less than or equal to 80 nucleobases, are described as follows:

Let R(n, n+m−1) be a region from a target nucleobase sequence, where “n” is the 5′-most nucleobase position of the region, where “n+m−1” is the 3′-most nucleobase position of the region and where “m” is the length of the region. A set “S(m)”, of regions of length “m” is defined as the regions where n ranges from 1 to L−m+1, where L is the length of the target nucleobase sequence and L>m. A set, “A”, of all regions can be constructed as a union of the sets of regions for each length from where m is greater than or equal to 8 and is less than or equal to 80.

This set of regions can be represented using the following mathematical notation:

$\begin{matrix} {A = {\bigcup\limits_{m}{S(m)}}} & {where} & \left. {m \in N} \middle| {8 \leq m \leq 80} \right. \end{matrix}$

and S(m)={R _(n,n+m−1) |nε{1,2,3, . . . , L−m+1}}

where the mathematical operator | indicates “such that”,

where the mathematical operator ε indicates “a member of a set” (e.g. yεZ indicates that element y is a member of set Z),

where x is a variable,

where N indicates all natural numbers, defined as positive integers,

and where the mathematical operator ∪ indicates “the union of sets”.

For example, the set of regions for m equal to 8, 9 and 80 can be constructed in the following manner. The set of regions, each 8 nucleobases in length, S(m=8), in a target nucleobase sequence 100 nucleobases in length (L=100), beginning at position 1 (n=1) of the target nucleobase sequence, can be created using the following expression: S(8)={R _(1,8) |nε{1,2,3, . . . ,93}} and describes the set of regions comprising nucleobases 1-8, 2-9,3-10, 4-11, 5-12, 6-13, 7-14, 8-15, 9-16, 10-17, 11-18, 12-19, 13-20, 14-21, 15-22, 16-23, 17-24, 18-25, 19-26, 20-27, 21-28, 22-29, 23-30, 24-31, 25-32, 26-33, 27-34, 28-35, 29-36, 30-37, 31-38, 32-39, 33-40, 34-41, 35-42, 36-43, 37-44, 38-45, 39-46, 40-47, 41-48, 42-49, 43-50, 44-51, 45-52, 46-53, 47-54, 48-55, 49-56, 50-57, 51-58, 52-59, 53-60, 54-61, 55-62, 56-63, 57-64, 58-65, 59-66, 60-67, 61-68, 62-69, 63-70, 64-71, 65-72, 66-73, 67-74, 68-75, 69-76, 70-77, 71-78, 72-79, 73-80, 74-81, 75-82, 76-83, 77-84, 78-85, 79-86, 80-87, 81-88, 82-89, 83-90, 84-91, 85-92, 86-93, 87-94, 88-95, 89-96, 90-97, 91-98, 92-99, 93-100.

An additional set for regions 20 nucleobases in length, in a target sequence 100 nucleobases in length, beginning at position 1 of the target nucleobase sequence, can be described using the following expression: S(20)={R _(1,20) |nε{1,2,3, . . . ,81}} and describes the set of regions comprising nucleobases 1-20, 2-21, 3-22, 4-23, 5-24, 6-25, 7-26, 8-27, 9-28, 10-29, 11-30, 12-31, 13-32, 14-33, 15-34, 16-35, 17-36, 18-37, 19-38, 20-39, 21-40, 22-41, 23-42, 24-43, 25-44, 26-45, 27-46, 28-47, 29-48, 30-49, 31-50, 32-51, 33-52, 34-53, 35-54, 36-55, 37-56, 38-57, 39-58, 40-59, 41-60, 42-61, 43-62, 44-63, 45-64, 46-65, 47-66, 48-67, 49-68, 50-69, 51-70, 52-71, 53-72, 54-73, 55-74, 56-75, 57-76, 58-77, 59-78, 60-79, 61-80, 62-81, 63-82, 64-83, 65-84, 66-85, 67-86, 68-87, 69-88, 70-89, 71-90, 72-91, 73-92, 74-93, 75-94, 76-95, 77-96, 78-97, 79-98, 80-99, 81-100.

An additional set for regions 80 nucleobases in length, in a target sequence 100 nucleobases in length, beginning at position 1 of the target nucleobase sequence, can be described using the following expression: S(80)={R _(1,80) |nε{1,2,3, . . . ,21}} and describes the set of regions comprising nucleobases 1-80, 2-81, 3-82, 4-83, 5-84, 6-85, 7-86, 8-87, 9-88, 10-89, 11-90, 12-91, 13-92, 14-93, 15-94, 16-95, 17-96, 18-97, 19-98, 20-99, 21-100.

Thus, in this example, A would include regions 1-8,2-9, 3-10 . . . 93-100, 1-20, 2-21, 3-22 . . . 81-100, 1-80, 2-81, 3-82 . . . 21-100.

The union of these aforementioned example sets and other sets for lengths from 10 to 19 and 21 to 79 can be described using the mathematical expression:

$A = {\bigcup\limits_{m}{S(m)}}$ where ∪ represents the union of the sets obtained by combining all members of all sets.

The mathematical expressions described herein define all possible target regions in a target nucleobase sequence of any length L, where the region is of length m, and where m is greater than or equal to 8 and less than or equal to 80 nucleobases and, and where m is less than L, and where n is less than L−m+1.

In one embodiment, the oligonucleotide compounds of this invention are 100% complementary to these sequences or to small sequences found within each of the above listed sequences. In another embodiment the oligonucleotide compounds have from at least 3 or 5 mismatches per 20 consecutive nucleobases in individual nucleobase positions to these target regions. Still other compounds of the invention are targeted to overlapping regions of the above-identified portions of the C-reactive protein sequence.

D. Screening and Target Validation

In a further embodiment, the “preferred target segments” identified herein may be employed in a screen for additional compounds that modulate the expression of C-reactive protein. “Modulators” are those compounds that decrease or increase the expression of a nucleic acid molecule encoding C-reactive protein and which comprise at least an 8-nucleobase portion that is complementary to a preferred target segment. The screening method comprises the steps of contacting a preferred target segment of a nucleic acid molecule encoding C-reactive protein with one or more candidate modulators, and selecting for one or more candidate modulators which decrease or increase the expression of a nucleic acid molecule encoding C-reactive protein. Once it is shown that the candidate modulator or modulators are capable of modulating (e.g. either decreasing or increasing) the expression of a nucleic acid molecule encoding C-reactive protein, the modulator may then be employed in further investigative studies of the function of C-reactive protein, or for use as a research, diagnostic, or therapeutic agent in accordance with the present invention.

The preferred target segments of the present invention may be also be combined with their respective complementary antisense compounds of the present invention to form stabilized double-stranded (duplexed) oligonucleotides.

Such double stranded oligonucleotide moieties have been shown in the art to modulate target expression and regulate translation as well as RNA processsing via an antisense mechanism. Moreover, the double-stranded moieties may be subject to chemical modifications (Fire et al., Nature, 1998, 391, 806-811; Timmons and Fire, Nature 1998, 395, 854; Timmons et al., Gene, 2001, 263, 103-112; Tabara et al., Science, 1998, 282, 430-431; Montgomery et al., Proc. Natl. Acad. Sci. USA, 1998, 95, 15502-15507; Tuschl et al., Genes Dev., 1999, 13, 3191-3197; Elbashir et al., Nature, 2001, 411, 494-498; Elbashir et al., Genes Dev. 2001, 15, 188-200). For example, such double-stranded moieties have been shown to inhibit the target by the classical hybridization of antisense strand of the duplex to the target, thereby triggering enzymatic degradation of the target (Tijsterman et al., Science, 2002, 295, 694-697).

The compounds of the present invention can also be applied in the areas of drug discovery and target validation. The present invention comprehends the use of the compounds and preferred target segments identified herein in drug discovery efforts to elucidate relationships that exist between C-reactive protein and a disease state, phenotype, or condition. These methods include detecting or modulating C-reactive protein comprising contacting a sample, tissue, cell, or organism with the compounds of the present invention, measuring the nucleic acid or protein level of C-reactive protein and/or a related phenotypic or chemical endpoint at some time after treatment, and optionally comparing the measured value to a non-treated sample or sample treated with a further compound of the invention. These methods can also be performed in parallel or in combination with other experiments to determine the function of unknown genes for the process of target validation or to determine the validity of a particular gene product as a target for treatment or prevention of a particular disease, condition, or phenotype.

E. Kits, Research Reagents, Diagnostics, and Therapeutics

The compounds of the present invention are utilized for diagnostics, therapeutics, prophylaxis and as research reagents and kits. Furthermore, antisense oligonucleotides, which are able to inhibit gene expression with exquisite specificity, are often used by those of ordinary skill to elucidate the function of particular genes or to distinguish between functions of various members of a biological pathway.

For use in kits and diagnostics, the compounds of the present invention, either alone or in combination with other compounds or therapeutics, are used as tools in differential and/or combinatorial analyses to elucidate expression patterns of a portion or the entire complement of genes expressed within cells and tissues.

As used herein the term “biological system” or “system” is defined as any organism, cell, cell culture or tissue that expresses, or is made competant to express products of the gene encoding C-reactive protein. These include, but are not limited to, humans, transgenic animals, cells, cell cultures, tissues, xenografts, transplants and combinations thereof.

As one nonlimiting example, expression patterns within cells or tissues treated with one or more antisense compounds are compared to control cells or tissues not treated with antisense compounds and the patterns produced are analyzed for differential levels of gene expression as they pertain, for example, to disease association, signaling pathway, cellular localization, expression level, size, structure or function of the genes examined. These analyses can be performed on stimulated or unstimulated cells and in the presence or absence of other compounds that affect expression patterns.

Examples of methods of gene expression analysis known in the art include DNA arrays or microarrays (Brazma and Vilo, FEBS Lett., 2000, 480, 17-24; Celis, et al., FEBS Lett., 2000, 480, 2-16), SAGE (serial analysis of gene expression)(Madden, et al., Drug Discov. Today, 2000, 5, 415-425), READS (restriction enzyme amplification of digested cDNAs) (Prashar and Weissman, Methods Enzymol., 1999, 303, 258-72), TOGA (total gene expression analysis) (Sutcliffe, et al., Proc. Natl. Acad. Sci. U.S.A., 2000, 97, 1976-81), protein arrays and proteomics (Celis, et al., FEBS Lett., 2000, 480, 2-16; Jungblut, et al., Electrophoresis, 1999, 20, 2100-10), expressed sequence tag (EST) sequencing (Celis, et al., FEBS Lett., 2000, 480, 2-16; Larsson, et al., J. Biotechnol., 2000, 80, 143-57), subtractive RNA fingerprinting (SuRF) (Fuchs, et al., Anal. Biochem., 2000, 286, 91-98; Larson, et al., Cytometry, 2000, 41, 203-208), subtractive cloning, differential display (DD) (Jurecic and Belmont, Curr. Opin. Microbiol., 2000, 3, 316-21), comparative genomic hybridization (Carulli, et al., J. Cell Biochem. Suppl., 1998, 31, 286-96), FISH (fluorescent in situ hybridization) techniques (Going and Gusterson, Eur. J. Cancer, 1999, 35, 1895-904) and mass spectrometry methods (To, Comb. Chem. High Throughput Screen, 2000, 3, 235-41).

The compounds of the invention are useful for research and diagnostics, because these compounds hybridize to nucleic acids encoding C-reactive protein. Primers and probes are useful in methods requiring the specific detection of nucleic acid molecules encoding C-reactive protein and in the amplification of said nucleic acid molecules for detection or for use in further studies of C-reactive protein. Hybridization of the primers and probes disclosed herein with a nucleic acid encoding C-reactive protein can be detected by means known in the art. Such means may include conjugation of an enzyme to the primers and probes, radiolabelling of the primers and probes or any other suitable detection means. Kits using such detection means for detecting the level of C-reactive protein in a sample may also be prepared.

The invention further provides for the use of a compound or composition of the invention in the manufacture of a medicament for the treatment of any and all conditions disclosed herein.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, neurological conditions including obstructive sleep apnea, Alzheimer's disease, ALS, Parkinson's disease, various ataxias, and macular degeneration.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, metabolic conditions including obesity, metabolic syndrome, and diabetes.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, cardiovascular conditions including sudden cardiac death, coronary artery disease (CAD), unstable angina, stroke, elective stent placement, angioplasty, atherosclerosis, post percutaneous transluminal angioplasty (PTCA), post peripheral vascular disease, post myocardial infarction (MI), cardiac transplantation, hypertension, mitral valve commissurotomy, thrombosis, deep vein thrombus, end-stage renal disease (ESRD), renal dialysis, complement activation, congestive heart failure, systemic vasculitis, and cardiopulmonary bypass

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, women's health conditions including premenstrual syndrome (PMS) and dysmenorhhoea.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, inflammatory diseases including gingivitis, inflammatory bowel disease, ulcerative colitis, rheumatoid arthritis, osteoarthritis, and axial spondyloarthritis.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, infectious diseases including HIV-associated rheumatic disorders and bacterial infection.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, pulmonary conditions including asthma and chronic obstructive pulmonary disease.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, musculoskeletal conditions including lower back pain, intense physical exercise, endurance training, and age-related disorders.

Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, cancers including pulmonary cancer and colon cancer.

Among diagnostic uses is the measurement of C-reactive protein levels in patients to identify those who may benefit from a treatment stategy aimed at attenuation of inflammation. Such patients suitable for diagnosis include patients with coronary artery stenting, e.g., to diagnose tendencies for myocardial infarction or patients with ESRD or other symptoms related to renal disorders, e.g., hypertension, duresis, renal failure.

The specificity and sensitivity of antisense are also harnessed by those of skill in the art for therapeutic uses. Antisense compounds have been employed as therapeutic moieties in the treatment of disease states in animals, including humans. Antisense oligonucleotide drugs, including ribozymes, have been safely and effectively administered to humans and numerous clinical trials are presently underway. It is thus established that antisense compounds can be useful therapeutic modalities that can be configured to be useful in treatment regimes for the treatment of cells, tissues and animals, especially humans.

For therapeutics, an animal, preferably a human, suspected of having a disease or disorder that can be treated by modulating the expression of C-reactive protein is treated by administering antisense compounds in accordance with this invention. For example, in one non-limiting embodiment, the methods comprise the step of administering to the animal in need of treatment, a therapeutically effective amount of a C-reactive protein inhibitor. The C-reactive protein inhibitors of the present invention effectively inhibit the activity of the C-reactive protein or inhibit the expression of the C-reactive protein. For example, such a compound or composition that reduces levels of C-reactive protein is useful to prevent morbidity and mortality for subjects with acute coronary syndrome. Such a composition is useful for reducing inflammation mediated by C-reactive protein in a subject, e.g., to treat or prevent or reduce the progression of, atherosclerosis; to treat or prevent or reduce the progression of, acute vascular damage at atherosclerotic plaque sites or in coronary arteries; or to treat or prevent or reduce the progression of, damage caused by inflammation associated with myocardial infarctions or renal inflammation. Still other therapeutic or prophylactic methods using the C-reactive protein inhibitory compounds of this invention include to treat patients with coronary artery stenting; or to treat patients with ESRD or other renal diseases or related inflammatory disorders.

In one embodiment, the activity or expression of C-reactive protein in an animal is inhibited by about 10%. Preferably, the activity or expression of C-reactive protein in an animal is inhibited by about 30%. More preferably, the activity or expression of C-reactive protein in an animal is inhibited by 50% or more. Thus, the oligomeric compounds modulate expression of C-reactive protein mRNA by at least 10%, by at least 20%, by at least 25%, by at least 30%, by at least 40%, by at least 50%, by at least 60%, by at least 70%, by at least 75%, by at least 80%, by at least 85%, by at least 90%, by at least 95%, by at least 98%, by at least 99%, or by 100%.

For example, the reduction of the expression of C-reactive protein may be measured in serum, adipose tissue, liver or any other body fluid, tissue or organ of the animal. Preferably, the cells contained within said fluids, tissues or organs being analyzed contain a nucleic acid molecule encoding C-reactive protein and/or C-reactive protein itself.

The compounds of the invention can be utilized in pharmaceutical compositions by adding an effective amount of a compound to a suitable pharmaceutically acceptable diluent or carrier. Use of the compounds and methods of the invention may also be useful prophylactically.

F. Modifications

As is known in the art, a nucleoside is a base-sugar combination. The base portion of the nucleoside is normally a heterocyclic base. The two most common classes of such heterocyclic bases are the purines and the pyrimidines. Nucleotides are nucleosides that further include a phosphate group covalently linked to the sugar portion of the nucleoside. For those nucleosides that include a pentofuranosyl sugar, the phosphate group can be linked to either the 2′, 3′ or 5′ hydroxyl moiety of the sugar. In forming oligonucleotides, the phosphate groups covalently link adjacent nucleosides to one another to form a linear polymeric compound. In turn, the respective ends of this linear polymeric compound can be further joined to form a circular compound, however, linear compounds are generally preferred. In addition, linear compounds may have internal nucleobase complementarity and may therefore fold in a manner as to produce a fully or partially double-stranded compound. Within oligonucleotides, the phosphate groups are commonly referred to as forming the internucleoside backbone of the oligonucleotide. The normal linkage or backbone of RNA and DNA is a 3′ to 5′ phosphodiester linkage.

Modified Internucleoside Linkages (Backbones)

Specific examples of preferred antisense compounds useful in this invention include oligonucleotides containing modified backbones or non-natural internucleoside linkages. As defined in this specification, oligonucleotides having modified backbones include those that retain a phosphorus atom in the backbone and those that do not have a phosphorus atom in the backbone. For the purposes of this specification, and as sometimes referenced in the art, modified oligonucleotides that do not have a phosphorus atom in their internucleoside backbone can also be considered to be oligonucleosides.

Preferred modified oligonucleotide backbones containing a phosphorus atom therein include, for example, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkylphosphotriesters, methyl and other alkyl phosphonates including 3′-alkylene phosphonates, 5′-alkylene phosphonates and chiral phosphonates, phosphinates, phosphoramidates including 3′-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, selenophosphates and boranophosphates having normal 3′-5′ linkages, 2′-5′ linked analogs of these, and those having inverted polarity wherein one or more internucleotide linkages is a 3′ to 3′, 5′ to 5′ or 2′ to 2′ linkage. Preferred oligonucleotides having inverted polarity comprise a single 3′ to 3′ linkage at the 3′-most internucleotide linkage i.e. a single inverted nucleoside residue that may be abasic (the nucleobase is missing or has a hydroxyl group in place thereof). Various salts, mixed salts and free acid forms are also included.

Representative United States patents that teach the preparation of the above phosphorus-containing linkages include, but are not limited to, U.S. Pat. Nos. 3,687,808; 4,469,863; 4,476,301; 5,023,243; 5,177,196; 5,188,897; 5,264,423; 5,276,019; 5,278,302; 5,286,717; 5,321,131; 5,399,676; 5,405,939; 5,453,496; 5,455,233; 5,466,677; 5,476,925; 5,519,126; 5,536,821; 5,541,306; 5,550,111; 5,563,253; 5,571,799; 5,587,361; 5,194,599; 5,565,555; 5,527,899; 5,721,218; 5,672,697 and 5,625,050, certain of which are commonly owned with this application, and each of which is herein incorporated by reference.

Preferred modified oligonucleotide backbones that do not include a phosphorus atom therein have backbones that are formed by short chain alkyl or cycloalkyl internucleoside linkages, mixed heteroatom and alkyl or cycloalkyl internucleoside linkages, or one or more short chain heteroatomic or heterocyclic internucleoside linkages. These include those having morpholino linkages (formed in part from the sugar portion of a nucleoside); siloxane backbones; sulfide, sulfoxide and sulfone backbones; formacetyl and thioformacetyl backbones; methylene formacetyl and thioformacetyl backbones; riboacetyl backbones; alkene containing backbones; sulfamate backbones; methyleneimino and methylenehydrazino backbones; sulfonate and sulfonamide backbones; amide backbones; and others having mixed N, O, S and CH₂ component parts.

Representative United States patents that teach the preparation of the above oligonucleosides include, but are not limited to, U.S. Pat. Nos. 5,034,506; 5,166,315; 5,185,444; 5,214,134; 5,216,141; 5,235,033; 5,264,562; 5,264,564; 5,405,938; 5,434,257; 5,466,677; 5,470,967; 5,489,677; 5,541,307; 5,561,225; 5,596,086; 5,602,240; 5,610,289; 5,602,240; 5,608,046; 5,610,289; 5,618,704; 5,623,070; 5,663,312; 5,633,360; 5,677,437; 5,792,608; 5,646,269 and 5,677,439, certain of which are commonly owned with this application, and each of which is herein incorporated by reference.

Modified Sugar and Internucleoside Linkages-Mimetics

In other preferred oligonucleotide mimetics, both the sugar and the internucleoside linkage (i.e. the backbone), of the nucleotide units are replaced with novel groups. The nucleobase units are maintained for hybridization with an appropriate target nucleic acid. One such compound, an oligonucleotide mimetic that has been shown to have excellent hybridization properties, is referred to as a peptide nucleic acid (PNA). In PNA compounds, the sugar-backbone of an oligonucleotide is replaced with an amide containing backbone, in particular an aminoethylglycine backbone. The nucleobases are retained and are bound directly or indirectly to aza nitrogen atoms of the amide portion of the backbone. Representative United States patents that teach the preparation of PNA compounds include, but are not limited to, U.S. Pat. Nos. 5,539,082; 5,714,331; and 5,719,262, each of which is herein incorporated by reference. Further teaching of PNA compounds can be found in Nielsen et al., Science, 1991, 254, 1497-1500.

Further embodiments of the invention are oligonucleotides with phosphorothioate backbones and oligonucleosides with heteroatom backbones, and in particular —CH₂—NH—O—CH₂—, —CH₂—N(CH₃)—O—CH₂— [known as a methylene (methylimino) or MMI backbone], —CH₂—O—N(CH₃)—CH₂—, —CH₂—N (CH₃)—N(CH₃)—CH₂— and —O—N(CH₃)—CH₂—CH₂— [wherein the native phosphodiester backbone is represented as —O—P—O—CH₂—] of the above referenced U.S. Pat. No. 5,489,677, and the amide backbones of the above referenced U.S. Pat. No. 5,602,240. Also preferred are oligonucleotides having morpholino backbone structures of the above-referenced U.S. Pat. No. 5,034,506.

Modified Sugars

Modified oligonucleotides may also contain one or more substituted sugar moieties. Preferred oligonucleotides comprise one of the following at the 2′ position: OH; F; O-, S-, or N-alkyl; O-, S-, or N-alkenyl; O-, S- or N-alkynyl; or O-alkyl-O-alkyl, wherein the alkyl, alkenyl and alkynyl may be substituted or unsubstituted C₁ to C₁₀ alkyl or C₂ to C₁₀ alkenyl and alkynyl. Particularly preferred are O[(CH₂)_(n)O]_(m)CH₃, O(CH₂)_(n)OCH₃, O(CH₂)_(n)NH₂, O(CH₂)_(n)CH₃, O(CH₂)_(n)ONH₂, and O(CH₂)_(n)ON[(CH₂)_(n)CH₃]₂, where n and m are from 1 to about 10. Other preferred oligonucleotides comprise one of the following at the 2′ position: C₁ to C₁₀ lower alkyl, substituted lower alkyl, alkenyl, alkynyl, alkaryl, aralkyl, O-alkaryl or O-aralkyl, SH, SCH₃, OCN, Cl, Br, CN, CF₃, OCF₃, SOCH₃, SO₂CH₃, ONO₂, NO₂, N₃, NH₂, heterocycloalkyl, heterocycloalkaryl, aminoalkylamino, polyalkylamino, substituted silyl, an RNA cleaving group, a reporter group, an intercalator, a group for improving the pharmacokinetic properties of an oligonucleotide, or a group for improving the pharmacodynamic properties of an oligonucleotide, and other substituents having similar properties. A preferred modification includes 2′-O-methoxyethyl (2′-O—CH₂CH₂OCH₃, also known as 2′-O-(2-methoxyethyl) or 2′-methoxyethoxy or 2′-MOE) (Martin et al., Helv. Chim. Acta, 1995, 78, 486-504) i.e., an alkoxyalkoxy group. A further preferred modification includes 2′-dimethylaminooxyethoxy, i.e., a O(CH₂)₂ON(CH₃)₂ group, also known as 2′-DMAOE, as described in examples hereinbelow, and 2′-dimethylaminoethoxyethoxy (also known in the art as 2′-O-dimethyl-amino-ethoxy-ethyl or 2′-DMAEOE), i.e., 2′-O—CH₂—O—CH₂—N(CH₃)₂, also described in examples hereinbelow.

Other modifications include 2′-methoxy (2′-O—CH₃), 2′-aminopropoxy (2′-OCH₂CH₂CH₂NH₂), 2′-allyl (2′-CH₂—CH═CH₂), 2-O-allyl (2′-O—CH₂—CH═CH₂) and 2′-fluoro (2′-F). The 2′-modification may be in the arabino (up) position or ribo (down) position. A preferred 2′-arabino modification is 2′-F. Similar modifications may also be made at other positions on the oligonucleotide, particularly the 3′ position of the sugar on the 3′ terminal nucleotide or in 2′-5′ linked oligonucleotides and the 5′ position of 5′ terminal nucleotide. Oligonucleotides may also have sugar mimetics such as cyclobutyl moieties in place of the pentofuranosyl sugar. Representative United States patents that teach the preparation of such modified sugar structures include, but are not limited to, U.S. Pat. Nos. 4,981,957; 5,118,800; 5,319,080; 5,359,044; 5,393,878; 5,446,137; 5,466,786; 5,514,785; 5,519,134; 5,567,811; 5,576,427; 5,591,722; 5,597,909; 5,610,300; 5,627,053; 5,639,873; 5,646,265; 5,658,873; 5,670,633; 5,792,747; and 5,700,920, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference in its entirety.

A further modification of the sugar includes Locked Nucleic Acids (LNAs) in which the 2′-hydroxyl group is linked to the 3′ or 4′ carbon atom of the sugar ring, thereby forming a bicyclic sugar moiety. The linkage is preferably a methylene (—CH₂—)_(n) group bridging the 2′ oxygen atom and the 4′ carbon atom wherein n is 1 or 2. LNAs and preparation thereof are described in International Patent Publication Nos. WO 98/39352 and WO 99/14226.

Natural and Modified Nucleobases

Oligonucleotides may also include nucleobase (often referred to in the art simply as “base”) modifications or substitutions. As used herein, “unmodified” or “natural” nucleobases include the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C) and uracil (U). Modified nucleobases include other synthetic and natural nucleobases such as 5-methylcytosine (5-me-C), 5-hydroxymethyl cytosine, xanthine, hypoxanthine, 2-aminoadenine, 6-methyl and other alkyl derivatives of adenine and guanine, 2-propyl and other alkyl derivatives of adenine and guanine, 2-thiouracil, 2-thiothymine and 2-thiocytosine, 5-halouracil and cytosine, 5-propynyl (—C≡C—CH₃) uracil and cytosine and other alkynyl derivatives of pyrimidine bases, 6-azo uracil, cytosine and thymine, 5-uracil (pseudouracil), 4-thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl and other 8-substituted adenines and guanines, 5-halo particularly 5-bromo, 5-trifluoromethyl and other 5-substituted uracils and cytosines, 7-methylguanine and 7-methyladenine, 2-F-adenine, 2-amino-adenine, 8-azaguanine and 8-azaadenine, 7-deazaguanine and 7-deazaadenine and 3-deazaguanine and 3-deazaadenine. Further modified nucleobases include tricyclic pyrimidines such as phenoxazine cytidine(1H-pyrimido[5,4-b][1,4]benzoxazin-2(3H)-one), phenothiazine cytidine (1H-pyrimido[5,4-b][1,4]benzothiazin-2(3H)-one), G-clamps such as a substituted phenoxazine cytidine (e.g. 9-(2-aminoethoxy)-H-pyrimido[5,4-b][1,4]benzoxazin-2(3H)-one), carbazole cytidine (2H-pyrimido[4,5-b]indol-2-one), pyridoindole cytidine (H-pyrido[3′,2′:4,5]pyrrolo[2,3-d]pyrimidin-2-one). Modified nucleobases may also include those in which the purine or pyrimidine base is replaced with other heterocycles, for example 7-deaza-adenine, 7-deazaguanosine, 2-aminopyridine and 2-pyridone. Further nucleobases include those disclosed in U.S. Pat. No. 3,687,808, those disclosed in The Concise Encyclopedia Of Polymer Science And Engineering, pages 858-859, Kroschwitz, J. I., ed. John Wiley & Sons, 1990, those disclosed by Englisch et al., Angewandte Chemie, International Edition, 1991, 30, 613, and those disclosed by Sanghvi, Y. S., Chapter 15, Antisense Research and Applications, pages 289-302, Crooke, S. T. and Lebleu, B., ed., CRC Press, 1993. Certain of these nucleobases are particularly useful for increasing the binding affinity of the compounds of the invention. These include 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and O-6 substituted purines, including 2-aminopropyladenine, 5-propynyluracil and 5-propynylcytosine. 5-methylcytosine substitutions have been shown to increase nucleic acid duplex stability by 0.6-1.2° C. and are presently preferred base substitutions, even more particularly when combined with 2′-O-methoxyethyl sugar modifications.

Representative United States patents that teach the preparation of certain of the above noted modified nucleobases as well as other modified nucleobases include, but are not limited to, the above noted U.S. Pat. Nos. 3,687,808, as well as U.S. Pat. Nos. 4,845,205; 5,130,302; 5,134,066; 5,175,273; 5,367,066; 5,432,272; 5,457,187; 5,459,255; 5,484,908; 5,502,177; 5,525,711; 5,552,540; 5,587,469; 5,594,121, 5,596,091; 5,614,617; 5,645,985; 5,830,653; 5,763,588; 6,005,096; and 5,681,941, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference, and U.S. Pat. No. 5,750,692, which is commonly owned with the instant application and also herein incorporated by reference.

Conjugates

Another modification of the oligonucleotides of the invention involves chemically linking to the oligonucleotide one or more moieties or conjugates that enhance the activity, cellular distribution or cellular uptake of the oligonucleotide. These moieties or conjugates can include conjugate groups covalently bound to functional groups such as primary or secondary hydroxyl groups. Conjugate groups of the invention include intercalators, reporter molecules, polyamines, polyamides, polyethylene glycols, polyethers, groups that enhance the pharmacodynamic properties of oligomers, and groups that enhance the pharmacokinetic properties of oligomers. Typical conjugate groups include cholesterols, lipids, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes. Groups that enhance the pharmacodynamic properties, in the context of this invention, include groups that improve uptake, enhance resistance to degradation, and/or strengthen sequence-specific hybridization with the target nucleic acid. Groups that enhance the pharmacokinetic properties, in the context of this invention, include groups that improve uptake, distribution, metabolism or excretion of the compounds of the present invention. Representative conjugate groups are disclosed in International Patent Application PCT/US92/09196, filed Oct. 23, 1992, and U.S. Pat. No. 6,287,860, the entire disclosure of which are incorporated herein by reference. Conjugate moieties include but are not limited to lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g., hexyl-S-tritylthiol, a thiocholesterol, an aliphatic chain, e.g., dodecandiol or undecyl residues, a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethyl-ammonium 1,2-di-O-hexadecyl-rac-glycero-3-H-phosphonate, a polyamine or a polyethylene glycol chain, or adamantane acetic acid, a palmityl moiety, or an octadecylamine or hexylamino-carbonyl-oxycholesterol moiety. Oligonucleotides of the invention may also be conjugated to active drug substances, for example, aspirin, warfarin, phenylbutazone, ibuprofen, suprofen, fenbufen, ketoprofen, (S)-(+)-pranoprofen, carprofen, dansylsarcosine, 2,3,5-triiodobenzoic acid, flufenamic acid, folinic acid, a benzothiadiazide, chlorothiazide, a diazepine, indomethicin, a barbiturate, a cephalosporin, a sulfa drug, an antidiabetic, an antibacterial or an antibiotic. Oligonucleotide-drug conjugates and their preparation are described in U.S. patent application Ser. No. 09/334,130 (filed Jun. 15, 1999), which is incorporated herein by reference in its entirety.

Representative United States patents that teach the preparation of such oligonucleotide conjugates include, but are not limited to, U.S. Pat. Nos. 4,828,979; 4,948,882; 5,218,105; 5,525,465; 5,541,313; 5,545,730; 5,552,538; 5,578,717, 5,580,731; 5,580,731; 5,591,584; 5,109,124; 5,118,802; 5,138,045; 5,414,077; 5,486,603; 5,512,439; 5,578,718; 5,608,046; 4,587,044; 4,605,735; 4,667,025; 4,762,779; 4,789,737; 4,824,941; 4,835,263; 4,876,335; 4,904,582; 4,958,013; 5,082,830; 5,112,963; 5,214,136; 5,082,830; 5,112,963; 5,214,136; 5,245,022; 5,254,469; 5,258,506; 5,262,536; 5,272,250; 5,292,873; 5,317,098; 5,371,241, 5,391,723; 5,416,203, 5,451,463; 5,510,475; 5,512,667; 5,514,785; 5,565,552; 5,567,810; 5,574,142; 5,585,481; 5,587,371; 5,595,726; 5,597,696; 5,599,923; 5,599,928 and 5,688,941, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference.

Oligomeric compounds used in the compositions of the present invention can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of oligomeric compounds to enhance properties such as for example nuclease stability. Included in stabilizing groups are cap structures. By “cap structure or terminal cap moiety” is meant chemical modifications, which have been incorporated at either terminus of oligonucleotides (see for example International Patent Publication No. WO 97/26270, incorporated by reference herein). These terminal modifications protect the oligomeric compounds having terminal nucleic acid molecules from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5′-terminus (5′-cap) or at the 3′-terminus (3′-cap) or can be present on both termini. In non-limiting examples, the 5′-cap includes inverted abasic residue (moiety), 4′,5′-methylene nucleotide; 1-(beta-D-erythrofuranosyl) nucleotide, 4′-thio nucleotide, carbocyclic nucleotide; 1,5-anhydrohexitol nucleotide; L-nucleotides; alpha-nucleotides; modified base nucleotide; phosphorodithioate linkage; threo-pentofuranosyl nucleotide; acyclic 3′,4′-seco nucleotide; acyclic 3,4-dihydroxybutyl nucleotide; acyclic 3,5-dihydroxypentyl nucleotide, 3′-3′-inverted nucleotide moiety; 3′-3′-inverted abasic moiety; 3′-2′-inverted nucleotide moiety; 3′-2′-inverted abasic moiety; 1,4-butanediol phosphate; 3′-phosphoramidate; hexylphosphate; aminohexyl phosphate; 3′-phosphate; 3′-phosphorothioate; phosphorodithioate; or bridging or non-bridging methylphosphonate moiety (for more details see Wincott et al., International PCT publication No. WO 97/26270, incorporated by reference herein).

Particularly preferred 3′-cap structures of the present invention include, for example 4′,5′-methylene nucleotide; 1-(beta-D-erythrofuranosyl) nucleotide; 4′-thio nucleotide, carbocyclic nucleotide; 5′-amino-alkyl phosphate; 1,3-diamino-2-propyl phosphate, 3-aminopropyl phosphate; 6-aminohexyl phosphate; 1,2-aminododecyl phosphate; hydroxypropyl phosphate; 1,5-anhydrohexitol nucleotide; L-nucleotide; alpha-nucleotide; modified base nucleotide; phosphorodithioate; threo-pentofuranosyl nucleotide; acyclic 3′,4′-seco nucleotide; 3,4-dihydroxybutyl nucleotide; 3,5-dihydroxypentyl nucleotide, 5′-5′-inverted nucleotide moiety; 5′-5′-inverted abasic moiety; 5′-phosphoramidate; 5′-phosphorothioate; 1,4-butanediol phosphate; 5′-amino; bridging and/or non-bridging 5′-phosphoramidate, phosphorothioate and/or phosphorodithioate, bridging or non bridging methylphosphonate and 5′-mercapto moieties (for more details see Beaucage and Tyer, 1993, Tetrahedron 49, 1925; incorporated by reference herein).

Further 3′ and 5′-stabilizing groups that can be used to cap one or both ends of an oligomeric compound to impart nuclease stability include those disclosed in WO 03/004602 published on Jan. 16, 2003.

Chimeric Compounds

It is not necessary for all positions in a given compound to be uniformly modified, and in fact more than one of the aforementioned modifications may be incorporated in a single compound or even at a single nucleoside within an oligonucleotide.

The present invention also includes antisense compounds that are chimeric compounds. “Chimeric” antisense compounds or “chimeras,” in the context of this invention, are antisense compounds, particularly oligonucleotides, which contain two or more chemically distinct regions, each made up of at least one monomer unit, i.e., a nucleotide in the case of an oligonucleotide compound. These oligonucleotides typically contain at least one region wherein the oligonucleotide is modified so as to confer upon the oligonucleotide increased resistance to nuclease degradation, increased cellular uptake, increased stability and/or increased binding affinity for the target nucleic acid. An additional region of the oligonucleotide may serve as a substrate for enzymes capable of cleaving RNA:DNA or RNA:RNA hybrids. By way of example, RNAse H is a cellular endonuclease which cleaves the RNA strand of an RNA:DNA duplex. Activation of RNase H, therefore, results in cleavage of the RNA target, thereby greatly enhancing the efficiency of oligonucleotide-mediated inhibition of gene expression. The cleavage of RNA:RNA hybrids can, in like fashion, be accomplished through the actions of endoribonucleases, such as RNAseL which cleaves both cellular and viral RNA. Cleavage of the RNA target can be routinely detected by gel electrophoresis and, if necessary, associated nucleic acid hybridization techniques known in the art.

Preferred chimeric oligonucleotides are those disclosed in the Examples herein. Particularly preferred chimeric oligonucleotides are those referred to as ISIS 133726, ISIS 133719, ISIS 140177, ISIS 104183, ISIS 140180, ISIS 133731, ISIS 140187, ISIS 133712, ISIS 140194, ISIS 133730, and ISIS 133729.

Chimeric antisense compounds of the invention may be formed as composite structures of two or more oligonucleotides, modified oligonucleotides, oligonucleosides and/or oligonucleotide mimetics as described above. Chimeric antisense compounds can be of several different types. These include a first type wherein the “gap” segment of linked nucleosides is positioned between 5′ and 31 “wing” segments of linked nucleosides and a second “open end” type wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound. Oligonucleotides of the first type are also known in the art as “gapmers” or gapped oligonucleotides. Oligonucleotides of the second type are also known in the art as “hemimers” or “wingmers”. Such compounds have also been referred to in the art as hybrids. In a gapmer that is 20 nucleotides in length, a gap or wing can be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 or 18 nucleotides in length. In one embodiment, a 20-nucleotide gapmer is comprised of a gap 8 nucleotides in length, flanked on both the 5′ and 3′ sides by wings 6 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 10 nucleotides in length, flanked on both the 5′ and 3′ sides by wings 5 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 12 nucleotides in length flanked on both the 5′ and 3′ sides by wings 4 nucleotides in length. In a further embodiment, a 20-nucleotide gapmer is comprised of a gap 14 nucleotides in length flanked on both the 5′ and 3′ sides by wings 3 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 16 nucleotides in length flanked on both the 5′ and 3′ sides by wings 2 nucleotides in length. In a further embodiment, a 20-nucleotide gapmer is comprised of a gap 18 nucleotides in length flanked on both the 5′ and 3′ ends by wings 1 nucleotide in length. Alternatively, the wings are of different lengths, for example, a 20-nucleotide gapmer may be comprised of a gap 10 nucleotides in length, flanked by a 6-nucleotide wing on one side (5′ or 3′) and a 4-nucleotide wing on the other side (5′ or 3′).

In a hemimer, an “open end” chimeric antisense compound, 20 nucleotides in length, a gap segment, located at either the 5′ or 3′ terminus of the oligomeric compound, can be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 or 19 nucleotides in length. For example, a 20-nucleotide hemimer can have a gap segment of 10 nucleotides at the 5′ end and a second segment of 10 nucleotides at the 3′ end. Alternatively, a 20-nucleotide hemimer can have a gap segment of 10 nucleotides at the 3′ end and a second segment of 10 nucleotides at the 5′ end.

Representative United States patents that teach the preparation of such hybrid structures include, but are not limited to, U.S. Pat. Nos. 5,013,830; 5,149,797; 5,220,007; 5,256,775; 5,366,878; 5,403,711; 5,491,133; 5,565,350; 5,623,065; 5,652,355; 5,652,356; and 5,700,922, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference in its entirety.

G. Formulations

The compounds of the invention may also be admixed, encapsulated, conjugated or otherwise associated with other molecules, molecule structures or mixtures of compounds, as for example, liposomes, receptor-targeted molecules, oral, rectal, topical or other formulations, for assisting in uptake, distribution and/or absorption. Representative United States patents that teach the preparation of such uptake, distribution and/or absorption-assisting formulations include, but are not limited to, U.S. Pat. Nos. 5,108,921; 5,354,844; 5,416,016; 5,459,127; 5,521,291; 5,543,158; 5,547,932; 5,583,020; 5,591,721; 4,426,330; 4,534,899; 5,013,556; 5,108,921; 5,213,804; 5,227,170; 5,264,221; 5,356,633; 5,395,619; 5,416,016; 5,417,978; 5,462,854; 5,469,854; 5,512,295; 5,527,528; 5,534,259; 5,543,152; 5,556,948; 5,580,575; and 5,595,756, each of which is herein incorporated by reference.

The antisense compounds of the invention encompass any pharmaceutically acceptable salts, esters, or salts of such esters, or any other compound which, upon administration to an animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof.

The term “pharmaceutically acceptable salts” refers to physiologically and pharmaceutically acceptable salts of the compounds of the invention: i.e., salts that retain the desired biological activity of the parent compound and do not impart undesired toxicological effects thereto. For oligonucleotides, preferred examples of pharmaceutically acceptable salts and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.

The present invention also includes pharmaceutical compositions and formulations that include the antisense compounds of the invention. The pharmaceutical compositions of the present invention may be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be topical (including ophthalmic and to mucous membranes including vaginal and rectal delivery), pulmonary, e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal), oral or parenteral. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration. Oligonucleotides with at least one 2′-O-methoxyethyl modification are believed to be particularly useful for oral administration. Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders. Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable. Coated condoms, gloves and the like may also be useful.

The pharmaceutical formulations of the present invention, which may conveniently be presented in unit dosage form, may be prepared according to conventional techniques well known in the pharmaceutical industry. Such techniques include the step of bringing into association the active ingredients with the pharmaceutical carrier(s) or excipient(s). In general, the formulations are prepared by uniformly and intimately bringing into association the active ingredients with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.

The compositions of the present invention may be formulated into any of many possible dosage forms such as, but not limited to, tablets, capsules, gel capsules, liquid syrups, soft gels, suppositories, and enemas. The compositions of the present invention may also be formulated as suspensions in aqueous, non-aqueous or mixed media. Aqueous suspensions may further contain substances that increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran. The suspension may also contain stabilizers.

Pharmaceutical compositions of the present invention include, but are not limited to, solutions, emulsions, foams and liposome-containing formulations. The pharmaceutical compositions and formulations of the present invention may comprise one or more penetration enhancers, carriers, excipients or other active or inactive ingredients.

Emulsions are typically heterogenous systems of one liquid dispersed in another in the form of droplets usually exceeding 0.1 μm in diameter. Emulsions may contain additional components in addition to the dispersed phases, and the active drug that may be present as a solution in either the aqueous phase, oily phase or itself as a separate phase. Microemulsions are included as an embodiment of the present invention. Emulsions and their uses are well known in the art and are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.

Formulations of the present invention include liposomal formulations. As used in the present invention, the term “liposome” means a vesicle composed of amphiphilic lipids arranged in a spherical bilayer or bilayers. Liposomes are unilamellar or multilamellar vesicles which have a membrane formed from a lipophilic material and an aqueous interior that contains the composition to be delivered. Cationic liposomes are positively charged liposomes, which are believed to interact with negatively charged DNA molecules to form a stable complex. Liposomes that are pH-sensitive or negatively-charged are believed to entrap DNA rather than complex with it. Both cationic and noncationic liposomes have been used to deliver DNA to cells.

Liposomes also include “sterically stabilized” liposomes, a term which, as used herein, refers to liposomes comprising one or more specialized lipids. When incorporated into liposomes, these specialized lipids result in enhanced circulation lifetimes relative to liposomes lacking such specialized lipids. Examples of sterically stabilized liposomes are those in which part of the vesicle-forming lipid portion of the liposome comprises one or more glycolipids or is derivatized with one or more hydrophilic polymers, such as a polyethylene glycol (PEG) moiety. Liposomes and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.

The pharmaceutical formulations and compositions of the present invention may also include surfactants. The use of surfactants in drug products, formulations and in emulsions is well known in the art. Surfactants and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.

In one embodiment, the present invention employs various penetration enhancers to effect the efficient delivery of nucleic acids, particularly oligonucleotides. In addition to aiding the diffusion of non-lipophilic drugs across cell membranes, penetration enhancers also enhance the permeability of lipophilic drugs. Penetration enhancers may be classified as belonging to one of five broad categories, i.e., surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants. Penetration enhancers and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.

One of skill in the art will recognize that formulations are routinely designed according to their intended use, i.e. route of administration.

Preferred formulations for topical administration include those in which the oligonucleotides of the invention are in admixture with a topical delivery agent such as lipids, liposomes, fatty acids, fatty acid esters, steroids, chelating agents and surfactants. Preferred lipids and liposomes include neutral (e.g. dioleoylphosphatidyl DOPE ethanolamine, dimyristoylphosphatidyl choline DMPC, distearolyphosphatidyl choline) negative (e.g. dimyristoylphosphatidyl glycerol DMPG) and cationic (e.g. dioleoyltetramethylaminopropyl DOTAP and dioleoylphosphatidyl ethanolamine DOTMA).

For topical or other administration, oligonucleotides of the invention may be encapsulated within liposomes or may form complexes thereto, in particular to cationic liposomes. Alternatively, oligonucleotides may be complexed to lipids, in particular to cationic lipids. Preferred fatty acids and esters, pharmaceutically acceptable salts thereof, and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Topical formulations are described in detail in U.S. patent application Ser. No. 09/315,298 filed on May 20, 1999, which is incorporated herein by reference in its entirety.

Compositions and formulations for oral administration include powders or granules, microparticulates, nanoparticulates, suspensions or solutions in water or non-aqueous media, capsules, gel capsules, sachets, tablets or minitablets. Thickeners, flavoring agents, diluents, emulsifiers, dispersing aids or binders may be desirable. Preferred oral formulations are those in which oligonucleotides of the invention are administered in conjunction with one or more penetration enhancers surfactants and chelators. Preferred surfactants include fatty acids and/or esters or salts thereof, bile acids and/or salts thereof. Preferred bile acids/salts and fatty acids and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Also preferred are combinations of penetration enhancers, for example, fatty acids/salts in combination with bile acids/salts. A particularly preferred combination is the sodium salt of lauric acid, capric acid and UDCA. Further penetration enhancers include polyoxyethylene-9-lauryl ether, polyoxyethylene-20-cetyl ether. Oligonucleotides of the invention may be delivered orally, in granular form including sprayed dried particles, or complexed to form micro or nanoparticles. Oligonucleotide complexing agents and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Oral formulations for oligonucleotides and their preparation are described in detail in U.S. Patent Publication No. 2003/0040497 (Feb. 27, 2003) and its parent applications; U.S. Patent Publication No. 2003/0027780 (Feb. 6, 2003) and its parent applications; and U.S. patent application Ser. No. 10/071,822, filed Feb. 8, 2002, each of which is incorporated herein by reference in their entirety.

Compositions and formulations for parenteral, intrathecal or intraventricular administration may include sterile aqueous solutions that may also contain buffers, diluents and other suitable additives such as, but not limited to, penetration enhancers, carrier compounds and other pharmaceutically acceptable carriers or excipients.

Oligonucleotides may be formulated for delivery in vivo in an acceptable dosage form, e.g. as parenteral or non-parenteral formulations. Parenteral formulations include intravenous (IV), subcutaneous (SC), intraperitoneal (IP), intravitreal and intramuscular (IM) formulations, as well as formulations for delivery via pulmonary inhalation, intranasal administration, topical administration, etc. Non-parenteral formulations include formulations for delivery via the alimentary canal, e.g. oral administration, rectal administration, intrajejunal instillation, etc. Rectal administration includes administration as an enema or a suppository. Oral administration includes administration as a capsule, a gel capsule, a pill, an elixir, etc.

In some embodiments, an oligonucleotide may be administered to a subject via an oral route of administration. The subject may be an animal or a human (man). An animal subject may be a mammal, such as a mouse, a rat, a dog, a guinea pig, a monkey, a non-human primate, a cat or a pig. Non-human primates include monkeys and chimpanzees. A suitable animal subject may be an experimental animal, such as a mouse, rat, mouse, a rat, a dog, a monkey, a non-human primate, a cat or a pig.

In some embodiments, the subject may be a human. In certain embodiments, the subject may be a human patient in need of therapeutic treatment as discussed in more detail herein. In certain embodiments, the subject may be in need of modulation of expression of one or more genes as discussed in more detail herein. In some particular embodiments, the subject may be in need of inhibition of expression of one or more genes as discussed in more detail herein. In particular embodiments, the subject may be in need of modulation, i.e. inhibition or enhancement, of C-reactive protein in order to obtain therapeutic indications discussed in more detail herein.

In some embodiments, non-parenteral (e.g. oral) oligonucleotide formulations according to the present invention result in enhanced bioavailability of the oligonucleotide. In this context, the term “bioavailability” refers to a measurement of that portion of an administered drug, which reaches the circulatory system (e.g. blood, especially blood plasma) when a particular mode of administration is used to deliver the drug. Enhanced bioavailability refers to a particular mode of administration's ability to deliver oligonucleotide to the peripheral blood plasma of a subject relative to another mode of administration. For example, when a non-parenteral mode of administration (e.g. an oral mode) is used to introduce the drug into a subject, the bioavailability for that mode of administration may be compared to a different mode of administration, e.g. an IV mode of administration. In some embodiments, the area under a compound's blood plasma concentration curve (AUC₀) after non-parenteral (e.g. oral, rectal, intrajejunal) administration may be divided by the area under the drug's plasma concentration curve after intravenous (i.v.) administration (AUC_(iv)) to provide a dimensionless quotient (relative bioavailability, RB) that represents fraction of compound absorbed via the non-parenteral route as compared to the IV route. A composition's bioavailability is said to be enhanced in comparison to another composition's bioavailability when the first composition's relative bioavailability (RB₁) is greater than the second composition's relative bioavailability (RB₂).

In general, bioavailability correlates with therapeutic efficacy when a compound's therapeutic efficacy is related to the blood concentration achieved, even if the drug's ultimate site of action is intracellular (van Berge-Henegouwen et al., Gastroenterol., 1977, 73, 300). Bioavailability studies have been used to determine the degree of intestinal absorption of a drug by measuring the change in peripheral blood levels of the drug after an oral dose (DiSanto, Chapter 76 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, pages 1451-1458).

In general, an oral composition's bioavailability is said to be “enhanced” when its relative bioavailability is greater than the bioavailability of a composition substantially consisting of pure oligonucleotide, i.e. oligonucleotide in the absence of a penetration enhancer.

Organ bioavailability refers to the concentration of compound in an organ. Organ bioavailability may be measured in test subjects by a number of means, such as by whole-body radiography. Organ bioavailability may be modified, e.g. enhanced, by one or more modifications to the oligonucleotide, by use of one or more carrier compounds or excipients, etc. as discussed in more detail herein. In general, an increase in bioavailability will result in an increase in organ bioavailability.

Oral oligonucleotide compositions according to the present invention may comprise one or more “mucosal penetration enhancers,” also known as “absorption enhancers” or simply as “penetration enhancers.” Accordingly, some embodiments of the invention comprise at least one oligonucleotide in combination with at least one penetration enhancer. In general, a penetration enhancer is a substance that facilitates the transport of a drug across mucous membrane(s) associated with the desired mode of administration, e.g. intestinal epithelial membranes. Accordingly it is desirable to select one or more penetration enhancers that facilitate the uptake of an oligonucleotide, without interfering with the activity of the oligonucleotide, and in a such a manner the oligonucleotide can be introduced into the body of an animal without unacceptable side-effects such as toxicity, irritation or allergic response.

Embodiments of the present invention provide compositions comprising one or more pharmaceutically acceptable penetration enhancers, and methods of using such compositions, which result in the improved bioavailability of oligonucleotides administered via non-parenteral modes of administration. Heretofore, certain penetration enhancers have been used to improve the bioavailability of certain drugs. See Muranishi, Crit. Rev. Ther. Drug Carrier Systems, 1990, 7, 1 and Lee et al., Crit. Rev. Ther. Drug Carrier Systems, 1991, 8, 91. It has been found that the uptake and delivery of oligonucleotides, relatively complex molecules which are known to be difficult to administer to animals and man, can be greatly improved even when administered by non-parenteral means through the use of a number of different classes of penetration enhancers.

In some embodiments, compositions for non-parenteral administration include one or more modifications from naturally-occurring oligonucleotides (i.e. full-phosphodiester deoxyribosyl or full-phosphodiester ribosyl oligonucleotides). Such modifications may increase binding affinity, nuclease stability, cell or tissue permeability, tissue distribution, or other biological or pharmacokinetic property. Modifications may be made to the base, the linker, or the sugar, in general, as discussed in more detail herein with regards to oligonucleotide chemistry. In some embodiments of the invention, compositions for administration to a subject, and in particular oral compositions for administration to an animal or human subject, will comprise modified oligonucleotides having one or more modifications for enhancing affinity, stability, tissue distribution, or other biological property.

Suitable modified linkers include phosphorothioate linkers. In some embodiments according to the invention, the oligonucleotide has at least one phosphorothioate linker. Phosphorothioate linkers provide nuclease stability as well as plasma protein binding characteristics to the oligonucleotide. Nuclease stability is useful for increasing the in vivo lifetime of oligonucleotides, while plasma protein binding decreases the rate of first pass clearance of oligonucleotide via renal excretion. In some embodiments according to the present invention, the oligonucleotide has at least two phosphorothioate linkers. In some embodiments, wherein the oligonucleotide has exactly n nucleosides, the oligonucleotide has from one to n-1 phosphorothioate linkages. In some embodiments, wherein the oligonucleotide has exactly n nucleosides, the oligonucleotide has n-1 phosphorothioate linkages. In other embodiments wherein the oligonucleotide has exactly n nucleoside, and n is even, the oligonucleotide has from 1 to n/2 phosphorothioate linkages, or, when n is odd, from 1 to (n−1)/2 phosphorothioate linkages. In some embodiments, the oligonucleotide has alternating phosphodiester (PO) and phosphorothioate (PS) linkages. In other embodiments, the oligonucleotide has at least one stretch of two or more consecutive PO linkages and at least one stretch of two or more PS linkages. In other embodiments, the oligonucleotide has at least two stretches of PO linkages interrupted by at least on PS linkage.

In some embodiments, at least one of the nucleosides is modified on the ribosyl sugar unit by a modification that imparts nuclease stability, binding affinity or some other beneficial biological property to the sugar. In some cases, the sugar modification includes a 2′-modification, e.g. the 2′-OH of the ribosyl sugar is replaced or substituted. Suitable replacements for 2′-OH include 2′-F and 2′-arabino-F. Suitable substitutions for OH include 2′-O-alkyl, e.g. 2-O-methyl, and 2′-O-substituted alkyl, e.g. 2′-O-methoxyethyl, 2′-O-aminopropyl, etc. In some embodiments, the oligonucleotide contains at least one 2′-modification. In some embodiments, the oligonucleotide contains at least 2 2′-modifications. In some embodiments, the oligonucleotide has at least one 2′-modification at each of the termini (i.e. the 3′- and 5′-terminal nucleosides each have the same or different 2′-modifications). In some embodiments, the oligonucleotide has at least two sequential 2′-modifications at each end of the oligonucleotide. In some embodiments, oligonucleotides further comprise at least one deoxynucleoside. In particular embodiments, oligonucleotides comprise a stretch of deoxynucleosides such that the stretch is capable of activating RNase (e.g. RNase H) cleavage of an RNA to which the oligonucleotide is capable of hybridizing. In some embodiments, a stretch of deoxynucleosides capable of activating RNase-mediated cleavage of RNA comprises about 6 to about 16, e.g. about 8 to about 16 consecutive deoxynucleosides. In further embodiments, oligonucleotides are capable of eliciting cleavage by dsRNAse enzymes.

Oral compositions for administration of non-parenteral oligonucleotide compositions of the present invention may be formulated in various dosage forms such as, but not limited to, tablets, capsules, liquid syrups, soft gels, suppositories, and enemas. The term “alimentary delivery” encompasses e.g. oral, rectal, endoscopic and sublingual/buccal administration. A common requirement for these modes of administration is absorption over some portion or all of the alimentary tract and a need for efficient mucosal penetration of the nucleic acid(s) so administered.

Delivery of a drug via the oral mucosa, as in the case of buccal and sublingual administration, has several desirable features, including, in many instances, a more rapid rise in plasma concentration of the drug than via oral delivery (Harvey, Chapter 35 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, page 711).

Endoscopy may be used for drug delivery directly to an interior portion of the alimentary tract. For example, endoscopic retrograde cystopancreatography (ERCP) takes advantage of extended gastroscopy and permits selective access to the biliary tract and the pancreatic duct (Hirahata et al., Gan To Kagaku Ryoho, 1992, 19(10 Suppl.), 1591). Pharmaceutical compositions, including liposomal formulations, can be delivered directly into portions of the alimentary canal, such as, e.g., the duodenum (Somogyi et al., Pharm. Res., 1995, 12, 149) or the gastric submucosa (Akamo et al., Japanese J. Cancer Res., 1994, 85, 652) via endoscopic means. Gastric lavage devices (Inoue et al., Artif. Organs, 1997, 21, 28) and percutaneous endoscopic feeding devices (Pennington et al., Ailment Pharmacol. Ther., 1995, 9, 471) can also be used for direct alimentary delivery of pharmaceutical compositions.

In some embodiments, oligonucleotide formulations may be administered through the anus into the rectum or lower intestine. Rectal suppositories, retention enemas or rectal catheters can be used for this purpose and may be preferred when patient compliance might otherwise be difficult to achieve (e.g., in pediatric and geriatric applications, or when the patient is vomiting or unconscious). Rectal administration can result in more prompt and higher blood levels than the oral route. (Harvey, Chapter 35 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, page 711). Because about 50% of the drug that is absorbed from the rectum will bypass the liver, administration by this route significantly reduces the potential for first-pass metabolism (Benet et al., Chapter 1 In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Ed., Hardman et al., eds., McGraw-Hill, New York, N.Y., 1996).

One advantageous method of non-parenteral administration oligonucleotide compositions is oral delivery. Some embodiments employ various penetration enhancers in order to effect transport of oligonucleotides and other nucleic acids across mucosal and epithelial membranes. Penetration enhancers may be classified as belonging to one of five broad categories—surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, p. 92). Accordingly, some embodiments comprise oral oligonucleotide compositions comprising at least one member of the group consisting of surfactants, fatty acids, bile salts, chelating agents, and non-chelating surfactants. Further embodiments comprise oral oligonucleotide comprising at least one fatty acid, e.g. capric or lauric acid, or combinations or salts thereof. Other embodiments comprise methods of enhancing the oral bioavailability of an oligonucleotide, the method comprising co-administering the oligonucleotide and at least one penetration enhancer.

Other excipients that may be added to oral oligonucleotide compositions include surfactants (or “surface-active agents”), which are chemical entities which, when dissolved in an aqueous solution, reduce the surface tension of the solution or the interfacial tension between the aqueous solution and another liquid, with the result that absorption of oligonucleotides through the alimentary mucosa and other epithelial membranes is enhanced. In addition to bile salts and fatty acids, surfactants include, for example, sodium lauryl sulfate, polyoxyethylene-9-lauryl ether and polyoxyethylene-20-cetyl ether (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92); and perfluorohemical emulsions, such as FC-43 (Takahashi et al., J. Pharm. Phamacol., 1988, 40, 252).

Fatty acids and their derivatives which act as penetration enhancers and may be used in compositions of the present invention include, for example, oleic acid, lauric acid, capric acid (n-decanoic acid), myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein (1-monooleoyl-rac-glycerol), dilaurin, caprylic acid, arachidonic acid, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, acylcarnitines, acylcholines and mono- and di-glycerides thereof and/or physiologically acceptable salts thereof (i.e., oleate, laurate, caprate, myristate, palmitate, stearate, linoleate, etc.) (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; El-Hariri et al., J. Pharm. Pharmacol., 1992, 44, 651).

In some embodiments, oligonucleotide compositions for oral delivery comprise at least two discrete phases, which phases may comprise particles, capsules, gel-capsules, microspheres, etc. Each phase may contain one or more oligonucleotides, penetration enhancers, surfactants, bioadhesives, effervescent agents, or other adjuvant, excipient or diluent. In some embodiments, one phase comprises at least one oligonucleotide and at lease one penetration enhancer. In some embodiments, a first phase comprises at least one oligonucleotide and at least one penetration enhancer, while a second phase comprises at least one penetration enhancer. In some embodiments, a first phase comprises at least one oligonucleotide and at least one penetration enhancer, while a second phase comprises at least one penetration enhancer and substantially no oligonucleotide. In some embodiments, at least one phase is compounded with at least one degradation retardant, such as a coating or a matrix, which delays release of the contents of that phase. In some embodiments, a first phase comprises at least one oligonucleotide, at least one penetration enhancer, while a second phase comprises at least one penetration enhancer and a release-retardant. In particular embodiments, an oral oligonucleotide comprises a first phase comprising particles containing an oligonucleotide and a penetration enhancer, and a second phase comprising particles coated with a release-retarding agent and containing penetration enhancer.

A variety of bile salts also function as penetration enhancers to facilitate the uptake and bioavailability of drugs. The physiological roles of bile include the facilitation of dispersion and absorption of lipids and fat-soluble vitamins (Brunton, Chapter 38 In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Ed., Hardman et al., eds., McGraw-Hill, New York, N.Y., 1996, pages 934-935). Various natural bile salts, and their synthetic derivatives, act as penetration enhancers. Thus, the term “bile salt” includes any of the naturally occurring components of bile as well as any of their synthetic derivatives. The bile salts of the invention include, for example, cholic acid (or its pharmaceutically acceptable sodium salt, sodium cholate), dehydrocholic acid (sodium dehydrocholate), deoxycholic acid (sodium deoxycholate), glucholic acid (sodium glucholate), glycholic acid (sodium glycocholate), glycodeoxycholic acid (sodium glycodeoxycholate), taurocholic acid (sodium taurocholate), taurodeoxycholic acid (sodium taurodeoxycholate), chenodeoxycholic acid (CDCA, sodium chenodeoxycholate), ursodeoxycholic acid (UDCA), sodium tauro-24,25-dihydro-fusidate (STDHF), sodium glycodihydrofusidate and polyoxyethylene-9-lauryl ether (POE) (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Swinyard, Chapter 39 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, pages 782-783; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; Yamamoto et al., J. Pharm. Exp. Ther., 1992, 263, 25; Yamashita et al., J. Pharm. Sci., 1990, 79, 579).

In some embodiments, penetration enhancers useful in some embodiments of present invention are mixtures of penetration enhancing compounds. One such penetration enhancer is a mixture of UDCA (and/or CDCA) with capric and/or lauric acids or salts thereof e.g. sodium. Such mixtures are useful for enhancing the delivery of biologically active substances across mucosal membranes, in particular intestinal mucosa. Other penetration enhancer mixtures comprise about 5-95% of bile acid or salt(s) UDCA and/or CDCA with 5-95% capric and/or lauric acid. Particular penetration enhancers are mixtures of the sodium salts of UDCA, capric acid and lauric acid in a ratio of about 1:2:2 respectively. Anther such penetration enhancer is a mixture of capric and lauric acid (or salts thereof) in a 0.01:1 to 1:0.01 ratio (mole basis). In particular embodiments capric acid and lauric acid are present in molar ratios of e.g. about 0.1:1 to about 1:0.1, in particular about 0.5:1 to about 1:0.5.

Other excipients include chelating agents, i.e. compounds that remove metallic ions from solution by forming complexes therewith, with the result that absorption of oligonucelotides through the alimentary and other mucosa is enhanced. With regards to their use as penetration enhancers in the present invention, chelating agents have the added advantage of also serving as DNase inhibitors, as most characterized DNA nucleases require a divalent metal ion for catalysis and are thus inhibited by chelating agents (Jarrett, J. Chromatogr., 1993, 618, 315). Chelating agents of the invention include, but are not limited to, disodium ethylenediaminetetraacetate (EDTA), citric acid, salicylates (e.g., sodium salicylate, 5-methoxysalicylate and homovanilate), N-acyl derivatives of collagen, laureth-9 and N-amino acyl derivatives of beta-diketones (enamines)(Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; Buur et al., J. Control Rel., 1990, 14, 43).

As used herein, non-chelating non-surfactant penetration enhancers may be defined as compounds that demonstrate insignificant activity as chelating agents or as surfactants but that nonetheless enhance absorption of oligonucleotides through the alimentary and other mucosal membranes (Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1). This class of penetration enhancers includes, but is not limited to, unsaturated cyclic ureas, 1-alkyl- and 1-alkenylazacyclo-alkanone derivatives (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92); and non-steroidal anti-inflammatory agents such as diclofenac sodium, indomethacin and phenylbutazone (Yamashita et al., J. Pharm. Pharmacol., 1987, 39, 621).

Agents that enhance uptake of oligonucleotides at the cellular level may also be added to the pharmaceutical and other compositions of the present invention. For example, cationic lipids, such as lipofectin (Junichi et al, U.S. Pat. No. 5,705,188), cationic glycerol derivatives, and polycationic molecules, such as polylysine (Lollo et al., PCT Application WO 97/30731), can be used.

Some oral oligonucleotide compositions also incorporate carrier compounds in the formulation. As used herein, “carrier compound” or “carrier” can refer to a nucleic acid, or analog thereof, which may be inert (i.e., does not possess biological activity per se) or may be necessary for transport, recognition or pathway activation or mediation, or is recognized as a nucleic acid by in vivo processes that reduce the bioavailability of a nucleic acid having biological activity by, for example, degrading the biologically active nucleic acid or promoting its removal from circulation. The coadministration of a nucleic acid and a carrier compound, typically with an excess of the latter substance, can result in a substantial reduction of the amount of nucleic acid recovered in the liver, kidney or other extracirculatory reservoirs, presumably due to competition between the carrier compound and the nucleic acid for a common receptor. For example, the recovery of a partially phosphorothioate oligonucleotide in hepatic tissue can be reduced when it is coadministered with polyinosinic acid, dextran sulfate, polycytidic acid or 4-acetamido-4′ isothiocyano-stilbene-2, 2′-disulfonic acid (Miyao et al., Antisense Res. Dev., 1995, 5, 115; Takakura et al., Antisense & Nucl. Acid Drug Dev., 1996, 6, 177).

A “pharmaceutical carrier” or “excipient” may be a pharmaceutically acceptable solvent, suspending agent or any other pharmacologically inert vehicle for delivering one or more nucleic acids to an animal. The excipient may be liquid or solid and is selected, with the planned manner of administration in mind, so as to provide for the desired bulk, consistency, etc., when combined with a nucleic acid and the other components of a given pharmaceutical composition. Typical pharmaceutical carriers include, but are not limited to, binding agents (e.g., pregelatinised maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose, etc.); fillers (e.g., lactose and other sugars, microcrystalline cellulose, pectin, gelatin, calcium sulfate, ethyl cellulose, polyacrylates or calcium hydrogen phosphate, etc.); lubricants (e.g., magnesium stearate, talc, silica, colloidal silicon dioxide, stearic acid, metallic stearates, hydrogenated vegetable oils, corn starch, polyethylene glycols, sodium benzoate, sodium acetate, etc.); disintegrants (e.g., starch, sodium starch glycolate, EXPLOTAB™ disintegrating agent); and wetting agents (e.g., sodium lauryl sulphate, etc.).

Oral oligonucleotide compositions may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels. Thus, for example, the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipuritics, astringents, local anesthetics or anti-inflammatory agents, or may contain additional materials useful in physically formulating various dosage forms of the composition of present invention, such as dyes, flavoring agents, preservatives, antioxidants, opacifiers, thickening agents and stabilizers. However, such materials, when added, should not unduly interfere with the biological activities of the components of the compositions of the present invention.

Certain embodiments of the invention provide pharmaceutical compositions containing one or more oligomeric compounds and one or more other chemotherapeutic agents that function by a non-antisense mechanism. Examples of such chemotherapeutic agents include but are not limited to cancer chemotherapeutic drugs such as daunorubicin, daunomycin, dactinomycin, doxorubicin, epirubicin, idarubicin, esorubicin, bleomycin, mafosfamide, ifosfamide, cytosine ara-binoside, bis-chloroethylnitrosurea, busulfan, mitomycin C, actinomycin D, mithramycin, prednisone, hydroxyprogesterone, testosterone, tamoxifen, dacarbazine, procarbazine, hexamethylmelamine, pentamethylmelamine, mitoxantrone, amsacrine, chlorambucil, methylcyclohexylnitrosurea, nitrogen mustards, melphalan, cyclophosphamide, 6-mercaptopurine, 6-thioguanine, cytarabine, 5-azacytidine, hydroxyurea, deoxycoformycin, 4-hydroxyperoxycyclophosphoramide, 5-fluorouracil (5-FU), 5-fluorodeoxyuridine (5-FUdR), methotrexate (MTX), colchicine, taxol, vincristine, vinblastine, etoposide (VP-16), trimetrexate, irinotecan, topotecan, gemcitabine, teniposide, cisplatin and diethylstilbestrol (DES). When used with the compounds of the invention, such chemotherapeutic agents may be used individually (e.g., 5-FU and oligonucleotide), sequentially (e.g., 5-FU and oligonucleotide for a period of time followed by MTX and oligonucleotide), or in combination with one or more other such chemotherapeutic agents (e.g., 5-FU, MTX and oligonucleotide, or 5-FU, radiotherapy and oligonucleotide). Antiinflammatory drugs, including but not limited to nonsteroidal anti-inflammatory drugs and corticosteroids, and antiviral drugs, including but not limited to ribivirin, vidarabine, acyclovir and ganciclovir, may also be combined in compositions of the invention. Combinations of antisense compounds and other non-antisense drugs are also within the scope of this invention. Two or more combined compounds may be used together or sequentially.

In another related embodiment, compositions of the invention may contain one or more antisense compounds, particularly oligonucleotides, targeted to a first nucleic acid and one or more additional antisense compounds targeted to a second nucleic acid target. Alternatively, compositions of the invention may contain two or more antisense compounds targeted to different regions of the same nucleic acid target. Numerous examples of antisense compounds are known in the art. Two or more combined compounds may be used together or sequentially.

H. Dosing

The formulation of therapeutic compositions and their subsequent administration (dosing) is believed to be within the skill of those in the art. Dosing is dependent on severity and responsiveness of the disease state to be treated, with the course of treatment lasting from several days to several months, or until a cure is effected or a diminution of the disease state is achieved. Optimal dosing schedules can be calculated from measurements of drug accumulation in the body of the patient. Persons of ordinary skill can easily determine optimum dosages, dosing methodologies and repetition rates. Optimum dosages may vary depending on the relative potency of individual oligonucleotides, and can generally be estimated based on EC₅₀s found to be effective in in vitro and in vivo animal models. In general, dosage is from 0.01 μg to 100 g per kg of body weight, from 0.1 μg to 10 g per kg of body weight, from 1.0 μg to 1 g per kg of body weight, from 10.0 μg to 100 mg per kg of body weight, from 100 μg to 10 mg per kg of body weight, or from 1 mg to 5 mg per kg of body weight and may be given once or more daily, weekly, monthly or yearly, or even once every 2 to 20 years. Persons of ordinary skill in the art can easily estimate repetition rates for dosing based on measured residence times and concentrations of the drug in bodily fluids or tissues. Following successful treatment, it may be desirable to have the patient undergo maintenance therapy to prevent the recurrence of the disease state, wherein the oligonucleotide is administered in maintenance doses, ranging from 0.01 μg to 100 g per kg of body weight, once or more daily, to once every 20 years.

The effects of treatments with therapeutic compositions can be assessed following collection of tissues or fluids from a patient or subject receiving said treatments. It is known in the art that a biopsy sample can be procured from certain tissues without resulting in detrimental effects to a patient or subject. In certain embodiments, a tissue and its constituent cells comprise, but are not limited to, blood (e.g., hematopoietic cells, such as human hematopoietic progenitor cells, human hematopoietic stem cells, CD34⁺ cells CD4⁺ cells), lymphocytes and other blood lineage cells, bone marrow, breast, cervix, colon, esophagus, lymph node, muscle, peripheral blood, oral mucosa and skin. In other embodiments, a fluid and its constituent cells comprise, but are not limited to, blood, urine, semen, synovial fluid, lymphatic fluid and cerebro-spinal fluid. Tissues or fluids procured from patients can be evaluated for expression levels of the target mRNA or protein. Additionally, the mRNA or protein expression levels of other genes known or suspected to be associated with the specific disease state, condition or phenotype can be assessed. mRNA levels can be measured or evaluated by real-time PCR, Northern blot, in situ hybridization or DNA array analysis. Protein levels can be measured or evaluated by ELISA, immunoblotting, quantitative protein assays, protein activity assays (for example, caspase activity assays) immunohistochemistry or immunocytochemistry.

Furthermore, the effects of treatment can be assessed by measuring biomarkers associated with the disease or condition in the aforementioned tissues and fluids, collected from a patient or subject receiving treatment, by routine clinical methods known in the art. These biomarkers include but are not limited to: glucose, cholesterol, lipoproteins, triglycerides, free fatty acids and other markers of glucose and lipid metabolism; liver transaminases, bilirubin, albumin, blood urea nitrogen, creatine and other markers of kidney and liver function; interleukins, tumor necrosis factors, intracellular adhesion molecules, C-reactive protein and other markers of inflammation; testosterone, estrogen and other hormones; tumor markers; vitamins, minerals and electrolytes.

While the present invention has been described with specificity in accordance with certain of its preferred embodiments, the following examples serve only to illustrate the invention and are not intended to limit the same. Each of the references, GENBANK® accession numbers, and the like recited in the present application is incorporated herein by reference in its entirety.

EXAMPLES Example 1

Synthesis of Nucleoside Phosphoramidites

The following compounds, including amidites and their intermediates were prepared as described in U.S. Pat. No. 6,426,220 and International Patent Publication No. WO 02/36743; 5′-O-Dimethoxytrityl-thymidine intermediate for 5-methyl dC amidite, 5′-O-Dimethoxytrityl-2′-deoxy-5-methylcytidine intermediate for 5-methyl-dC amidite, 5′-O-Dimethoxytrityl-2′-deoxy-N-4-benzoyl-5-methylcytidine penultimate intermediate for 5-methyl dC amidite, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-deoxy-N⁴-benzoyl-5-methylcytidin-3′-O-yl ]-2-cyanoethyl-N,N-diisopropylphosphoramidite (5-methyl dC amidite), 2′-Fluorodeoxyadenosine, 2′-Fluorodeoxyguanosine, 2′-Fluorouridine, 2′-Fluorodeoxycytidine, 2′-O-(2-Methoxyethyl) modified amidites, 2′-O-(2-methoxyethyl)-5-methyluridine intermediate, 5′-O-DMT-2′-O-(2-methoxyethyl)-5-methyluridine penultimate intermediate, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-5-methyluridin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE T amidite), 5′-O-Dimethoxytrityl-2′-O-(2-methoxyethyl)-5-methylcytidine intermediate, 5′-O-dimethoxytrityl-2′-O-(2-methoxyethyl)-N⁴-benzoyl-5-methyl-cytidine penultimate intermediate, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N⁴-benzoyl-5-methylcytidin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE 5-Me-C amidite), [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N⁶-benzoyladenosin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE A amdite), [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N⁴-isobutyrylguanosin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE G amidite), 2′-O-(Aminooxyethyl) nucleoside amidites and 2′-O-(dimethylamino-oxyethyl) nucleoside amidites, 2′-(Dimethylaminooxyethoxy) nucleoside amidites, 5′-O-tert-Butyldiphenylsilyl-O₂-2′-anhydro-5-methyluridine, 5′-O-tert-Butyldiphenylsilyl-2′-O-(2-hydroxyethyl)-5-methyluridine, 2′-O-([2-phthalimidoxy)ethyl]-5′-t-butyldiphenylsilyl-5-methyluridine 5′-O-tert-butyldiphenylsilyl-2′-O-[(2-formadoximinooxy) ethyl]-5-methyluridine, 5′-O-tert-Butyldiphenylsilyl-2′-O-[N,N dimethylaminooxyethyl]-5-methyluridine, 2′-O-(dimethylaminooxyethyl)-5-methyluridine, 5′-O-DMT-2′-O-(dimethylaminooxyethyl)-5-methyluridine, 5′-O-DMT-2′-O-(2-N,N-dimethylaminooxyethyl)-5-methyluridine-3′-[(2-cyanoethyl)-N,N-diisopropylphosphoramidite], 2′-(Aminooxyethoxy) nucleoside amidites, N2-isobutyryl-6-O-diphenylcarbamoyl-2′-O-(2-ethylacetyl)-5′-O-(4,4′-dimethoxytrityl) guanosine-3′-[(2-cyanoethyl)-N,N-diisopropylphosphoramidite], 2′-dimethylaminoethoxyethoxy (2′-DMAEOE) nucleoside amidites, 2′-O-[2(2-N,N-dimethylaminoethoxy)ethyl]-5-methyl uridine, 5′-O-dimethoxytrityl-2′-O-[2(2-N,N-dimethylaminoethoxy)-ethyl)]-5-methyl uridine and 5′-O-Dimethoxytrityl-2′-O-[2(2-N,N-dimethylaminoethoxy)-ethyl)]-5-methyl uridine-3′-O-(cyanoethyl-N,N-diisopropyl)phosphoramidite.

Example 2 Oligonucleotide and Oligonucleoside Synthesis

The antisense compounds used in accordance with this invention may be conveniently and routinely made through the well-known technique of solid phase synthesis. Equipment for such synthesis is sold by several vendors including, for example, Applied Biosystems (Foster City, Calif.). Any other means for such synthesis known in the art may additionally or alternatively be employed. It is well known to use similar techniques to prepare oligonucleotides, such as the phosphorothioates and alkylated derivatives.

Oligonucleotides: Unsubstituted and substituted phosphodiester (P═O) oligonucleotides are synthesized on an automated DNA synthesizer (Applied Biosystems model 394) using standard phosphoramidite chemistry with oxidation by iodine.

Phosphorothioates (P═S) are synthesized similar to phosphodiester oligonucleotides with the following exceptions: thiation was effected by utilizing a 10% w/v solution of 3,H-1,2-benzodithiole-3-one 1,1-dioxide in acetonitrile for the oxidation of the phosphite linkages. The thiation reaction step time was increased to 180 seconds and preceded by the normal capping step. After cleavage from the CPG column and deblocking in concentrated ammonium hydroxide at 55° C. (12-16 hours), the oligonucleotides were recovered by precipitating with >3 volumes of ethanol from a 1 M NH₄OAc solution. Phosphinate oligonucleotides are prepared as described in U.S. Pat. No. 5,508,270, herein incorporated by reference.

Alkyl phosphonate oligonucleotides are prepared as described in U.S. Pat. No. 4,469,863, herein incorporated by reference.

3′-Deoxy-3′-methylene phosphonate oligonucleotides are prepared as described in U.S. Pat. No. 5,610,289 or 5,625,050, herein incorporated by reference.

Phosphoramidite oligonucleotides are prepared as described in U.S. Pat. Nos. 5,256,775 or U.S. Pat. No. 5,366,878, herein incorporated by reference.

Alkylphosphonothioate oligonucleotides are prepared as described in International Patent Application Nos. PCT/US94/00902 and PCT/US93/06976 (published as WO 94/17093 and WO 94/02499, respectively), herein incorporated by reference.

3′-Deoxy-3′-amino phosphoramidate oligonucleotides are prepared as described in U.S. Pat. No. 5,476,925, herein incorporated by reference.

Phosphotriester oligonucleotides are prepared as described in U.S. Pat. No. 5,023,243, herein incorporated by reference.

Borano phosphate oligonucleotides are prepared as described in U.S. Pat. Nos. 5,130,302 and 5,177,198, both herein incorporated by reference.

Oligonucleosides: Methylenemethylimino linked oligonucleosides, also identified as MMI linked oligonucleosides, methylenedimethylhydrazo linked oligonucleosides, also identified as MDH linked oligonucleosides, and methylenecarbonylamino linked oligonucleosides, also identified as amide-3 linked oligonucleosides, and methyleneaminocarbonyl linked oligonucleosides, also identified as amide-4 linked oligonucleosides, as well as mixed backbone compounds having, for instance, alternating MMI and P═O or P═S linkages are prepared as described in U.S. Pat. Nos. 5,378,825, 5,386,023, 5,489,677, 5,602,240 and 5,610,289, all of which are herein incorporated by reference.

Formacetal and thioformacetal linked oligonucleosides are prepared as described in U.S. Pat. Nos. 5,264,562 and 5,264,564, herein incorporated by reference.

Ethylene oxide linked oligonucleosides are prepared as described in U.S. Pat. No. 5,223,618, herein incorporated by reference.

Example 3

RNA Synthesis

In general, RNA synthesis chemistry is based on the selective incorporation of various protecting groups at strategic intermediary reactions. Although one of ordinary skill in the art will understand the use of protecting groups in organic synthesis, a useful class of protecting groups includes silyl ethers. In particular bulky silyl ethers are used to protect the 5′-hydroxyl in combination with an acid-labile orthoester protecting group on the 2′-hydroxyl. This set of protecting groups is then used with standard solid-phase synthesis technology. It is important to lastly remove the acid labile orthoester protecting group after all other synthetic steps. Moreover, the early use of the silyl protecting groups during synthesis ensures facile removal when desired, without undesired deprotection of 2′ hydroxyl.

Following this procedure for the sequential protection of the 5′-hydroxyl in combination with protection of the 2′-hydroxyl by protecting groups that are differentially removed and are differentially chemically labile, RNA oligonucleotides were synthesized.

RNA oligonucleotides are synthesized in a stepwise fashion. Each nucleotide is added sequentially (3′- to 5′-direction) to a solid support-bound oligonucleotide. The first nucleoside at the 3′-end of the chain is covalently attached to a solid support. The nucleotide precursor, a ribonucleoside phosphoramidite, and activator are added, coupling the second base onto the 5′-end of the first nucleoside. The support is washed and any unreacted 5′-hydroxyl groups are capped with acetic anhydride to yield 5′-acetyl moieties. The linkage is then oxidized to the more stable and ultimately desired P(V) linkage. At the end of the nucleotide addition cycle, the 5′-silyl group is cleaved with fluoride. The cycle is repeated for each subsequent nucleotide.

Following synthesis, the methyl protecting groups on the phosphates are cleaved in 30 minutes utilizing 1 M disodium-2-carbamoyl-2-cyanoethylene-1,1-dithiolate trihydrate (S₂Na₂) in DMF. The deprotection solution is washed from the solid support-bound oligonucleotide using water. The support is then treated with 40% methylamine in water for 10 minutes at 55° C. This releases the RNA oligonucleotides into solution, deprotects the exocyclic amines, and modifies the 2′-groups. The oligonucleotides can be analyzed by anion exchange HPLC at this stage.

The 2′-orthoester groups are the last protecting groups to be removed. The ethylene glycol monoacetate orthoester protecting group developed by Dharmacon Research, Inc. (Lafayette, Colo.), is one example of a useful orthoester protecting group, which has the following important properties. It is stable to the conditions of nucleoside phosphoramidite synthesis and oligonucleotide synthesis. However, after oligonucleotide synthesis the oligonucleotide is treated with methylamine, which not only cleaves the oligonucleotide from the solid support but also removes the acetyl groups from the orthoesters. The resulting 2-ethyl-hydroxyl substituents on the orthoester are less electron withdrawing than the acetylated precursor. As a result, the modified orthoester becomes more labile to acid-catalyzed hydrolysis. Specifically, the rate of cleavage is approximately 10 times faster after the acetyl groups are removed. Therefore, this orthoester possesses sufficient stability in order to be compatible with oligonucleotide synthesis. Yet, when subsequently modified, this orthoester permits deprotection to be carried out under relatively mild aqueous conditions compatible with the final RNA oligonucleotide product.

Additionally, methods of RNA synthesis are well known in the art (Scaringe, S. A. Ph.D. Thesis, University of Colorado, 1996; Scaringe, S. A., et al., J. Am. Chem. Soc., 1998, 120, 11820-11821; Matteucci, M. D. and Caruthers, M. H. J. Am. Chem. Soc., 1981, 103, 3185-3191; Beaucage, S. L. and Caruthers, M. H. Tetrahedron Lett., 1981, 22, 1859-1862; Dahl, B. J., et al., Acta Chem. Scand,. 1990, 44, 639-641; Reddy, M. P., et al., Tetrahedrom Lett., 1994, 25, 4311-4314; Wincott, F. et al., Nucleic Acids Res., 1995, 23, 2677-2684; Griffin, B. E., et al., Tetrahedron, 1967, 23, 2301-2313; Griffin, B. E., et al., Tetrahedron, 1967, 23, 2315-2331).

RNA antisense compounds (RNA oligonucleotides) of the present invention can be synthesized by the methods herein or purchased from Dharmacon Research, Inc (Lafayette, Colo.). Once synthesized, complementary RNA antisense compounds can then be annealed by methods known in the art to form double stranded (duplexed) antisense compounds. For example, duplexes can be formed by combining 30 μl of each of the complementary strands of RNA oligonucleotides (50 uM RNA oligonucleotide solution) and 15 μl of 5× annealing buffer (100 mM potassium acetate, 30 mM HEPES-KOH pH 7.4, 2 mM magnesium acetate) followed by heating for 1 minute at 90° C., then 1 hour at 37° C. The resulting duplexed antisense compounds can be used in kits, assays, screens, or other methods to investigate the role of a target nucleic acid.

Example 4 Synthesis of Chimeric Oligonucleotides

Chimeric oligonucleotides, oligonucleosides or mixed oligonucleotides/oligonucleosides of the invention can be of several different types. These include a first type wherein the “gap” segment of linked nucleosides is positioned between 5′ and 3′ “wing” segments of linked nucleosides and a second “open end” type wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound. Oligonucleotides of the first type are also known in the art as “gapmers” or gapped oligonucleotides. Oligonucleotides of the second type are also known in the art as “hemimers” or “wingmers”.

[2′-O-Me]-[2′-deoxy]-[2′-O-Me] Chimeric Phosphorothioate Oligonucleotides

Chimeric oligonucleotides having 2′-O-alkyl phosphorothioate and 2′-deoxy phosphorothioate oligonucleotide segments are synthesized using an Applied Biosystems automated DNA synthesizer Model 394, as above. Oligonucleotides are synthesized using the automated synthesizer and 2′-deoxy-5′-dimethoxytrityl-3′-O-phosphoramidite for the DNA portion and 5′-dimethoxytrityl-2′-O-methyl-3′-O-phosphoramidite for 5′ and 3′ wings. The standard synthesis cycle is modified by incorporating coupling steps with increased reaction times for the 5′-dimethoxytrityl-2′-O-methyl-3′-O-phosphoramidite. The fully protected oligonucleotide is cleaved from the support and deprotected in concentrated ammonia (NH₄OH) for 12-16 hours at 55° C. The deprotected oligo is then recovered by an appropriate method (precipitation, column chromatography, volume reduced in vacuo and analyzed spetrophotometrically for yield and for purity by capillary electrophoresis and by mass spectrometry.

[2′-O-(2-Methoxyethyl)]-[2′-deoxy]-[2′-O-(Methoxyethyl)] Chimeric Phosphorothioate Oligonucleotides

[2′-O-(2-methoxyethyl)]-[2′-deoxy]-[-2′-O-(methoxyethyl)] chimeric phosphorothioate oligonucleotides were prepared as per the procedure above for the 2′-O-methyl chimeric oligonucleotide, with the substitution of 2′-O-(methoxyethyl) amidites for the 2′-O-methyl amidites.

[2′-O-(2-Methoxyethyl)Phosphodiester]-[2′-deoxy Phosphorothioate]-[2′-O-(2-Methoxyethyl) Phosphodiester] Chimeric Oligonucleotides

[2′-O-(2-methoxyethyl phosphodiester]-[2′-deoxy phosphorothioate]-[2′-O-(methoxyethyl) phosphodiester] chimeric oligonucleotides are prepared as per the above procedure for the 2′-O-methyl chimeric oligonucleotide with the substitution of 2′-O-(methoxyethyl) amidites for the 2′-O-methyl amidites, oxidation with iodine to generate the phosphodiester internucleotide linkages within the wing portions of the chimeric structures and sulfurization utilizing 3,H-1,2 benzodithiole-3-one 1,1 dioxide (Beaucage Reagent) to generate the phosphorothioate internucleotide linkages for the center gap.

Other chimeric oligonucleotides, chimeric oligonucleosides and mixed chimeric oligonucleotides/oligonucleosides are synthesized according to U.S. Pat. No. 5,623,065, herein incorporated by reference.

Example 5 Design and Screening of Duplexed Antisense Compounds Targeting C-Reactive Protein

In accordance with the present invention, a series of nucleic acid duplexes comprising the antisense compounds of the present invention and their complements can be designed to target C-reactive protein. The nucleobase sequence of the antisense strand of the duplex comprises at least an 8-nucleobase portion of an oligonucleotide in Table 1. The ends of the strands may be modified by the addition of one or more natural or modified nucleobases to form an overhang. The sense strand of the dsRNA is then designed and synthesized as the complement of the antisense strand and may also contain modifications or additions to either terminus. For example, in one embodiment, both strands of the dsRNA duplex are complementary over the central nucleobases, each having overhangs at one or both termini. The antisense and sense strands of the duplex comprise from about 17 to 25 nucleotides, or from about 19 to 23 nucleotides. Alternatively, the antisense and sense strands comprise 20, 21 or 22 nucleotides.

For example, a duplex comprising an antisense strand having the sequence CGAGAGGCGGACGGGACCG (SEQ ID NO: 624) and having a two-nucleobase overhang of deoxythymidine(dT) has the following structure (Antisense SEQ ID NO: 625, Complement SEQ ID NO: 626):

Overhangs can range from 2 to 6 nucleobases and these nucleobases may or may not be complementary to the target nucleic acid. In another embodiment, the duplexes may have an overhang on only one terminus.

In another embodiment, a duplex comprising an antisense strand having the same sequence CGAGAGGCGGACGGGACCG (SEQ ID NO: 624) is prepared with blunt ends (no single stranded overhang) as shown (Antisense SEQ ID NO: 624, Complement SEQ ID NO: 627):

The RNA duplex can be unimolecular or bimolecular; i.e., the two strands can be part of a single molecule or may be separate molecules.

RNA strands of the duplex can be synthesized by methods disclosed herein or purchased from Dharmacon Research Inc., (Lafayette, Colo.). Once synthesized, the complementary strands are annealed. The single strands are aliquoted and diluted to a concentration of 50 μM. Once diluted, 30 μL of each strand is combined with 15 μL of a 5× solution of annealing buffer. The final concentration of said buffer is 100 mM potassium acetate, 30 mM HEPES-KOH pH 7.4, and 2 mM magnesium acetate. The final volume is 75 μL. This solution is incubated for 1 minute at 90° C. and then centrifuged for 15 seconds. The tube is allowed to sit for 1 hour at 37° C. at which time the dsRNA duplexes are used in experimentation. The final concentration of the dsRNA duplex is 20 μM. This solution can be stored frozen (−20° C.) and freeze-thawed up to 5 times.

Once prepared, the duplexed antisense compounds are evaluated for their ability to modulate C-reactive protein expression.

When cells reached 80% confluency, they are treated with duplexed antisense compounds of the invention. For cells grown in 96-well plates, wells are washed once with 200 μL OPTI-MEM™-1 reduced-serum medium (Gibco BRL) and then treated with 130 μL of OPTI-MEM™-1 medium containing 12 μg/mL LIPOFECTIN™ reagent (Gibco BRL) and the desired duplex antisense compound at a final concentration of 200 nM. After 5 hours of treatment, the medium is replaced with fresh medium. Cells are harvested 16 hours after treatment, at which time RNA is isolated and target reduction measured by RT-PCR.

Example 6

Oligonucleotide Isolation

After cleavage from the controlled pore glass solid support and deblocking in concentrated ammonium hydroxide at 55° C. for 12-16 hours, the oligonucleotides or oligonucleosides are recovered by precipitation out of 1 M NH₄OAc with >3 volumes of ethanol. Synthesized oligonucleotides were analyzed by electrospray mass spectroscopy (molecular weight determination) and by capillary gel electrophoresis and judged to be at least 70% full-length material. The relative amounts of phosphorothioate and phosphodiester linkages obtained in the synthesis were determined by the ratio of correct molecular weight relative to the −16 amu product (+/−32+/−48). For some studies oligonucleotides were purified by HPLC, as described by Chiang et al., J. Biol. Chem. 1991, 266, 18162-18171. Results obtained with HPLC-purified material were similar to those obtained with non-HPLC purified material.

Example 7

Oligonucleotide Synthesis—96 Well Plate Format

Oligonucleotides were synthesized via solid phase P(III) phosphoramidite chemistry on an automated synthesizer capable of assembling 96 sequences simultaneously in a 96-well format. Phosphodiester internucleotide linkages were afforded by oxidation with aqueous iodine. Phosphorothioate internucleotide linkages were generated by sulfurization utilizing 3,H-1,2 benzodithiole-3-one 1,1 dioxide (Beaucage Reagent) in anhydrous acetonitrile. Standard base-protected beta-cyanoethyl-diiso-propyl phosphoramidites were purchased from commercial vendors (e.g. PE-Applied Biosystems, Foster City, Calif., or Pharmacia, Piscataway, N.J.). Non-standard nucleosides are synthesized as per standard or patented methods. They are utilized as base protected beta-cyanoethyldiisopropyl phosphoramidites.

Oligonucleotides were cleaved from support and deprotected with concentrated NH₄OH at elevated temperature (55-60° C.) for 12-16 hours and the released product then dried in vacuo. The dried product was then re-suspended in sterile water to afford a master plate from which all analytical and test plate samples are then diluted utilizing robotic pipettors.

Example 8 Oligonucleotide Analysis—96-Well Plate Format

The concentration of oligonucleotide in each well was assessed by dilution of samples and UV absorption spectroscopy. The full-length integrity of the individual products was evaluated by capillary electrophoresis (CE) in either the 96-well format (Beckman P/ACE™ MDQ apparatus) or, for individually prepared samples, on a commercial CE apparatus (e.g., Beckman P/ACE™ 5000, ABI 270 apparatus). Base and backbone composition was confirmed by mass analysis of the compounds utilizing electrospray-mass spectroscopy. All assay test plates were diluted from the master plate using single and multi-channel robotic pipettors. Plates were judged to be acceptable if at least 85% of the compounds on the plate were at least 85% full length.

Example 9 Cell Culture and Oligonucleotide Treatment

The effect of antisense compounds on target nucleic acid expression can be tested in any of a variety of cell types provided that the target nucleic acid is present at measurable levels. This can be routinely determined using, for example, PCR or Northern blot analysis. The following cell types are provided for illustrative purposes, but other cell types can be routinely used, provided that the target is expressed in the cell type chosen. This can be readily determined by methods routine in the art, for example Northern blot analysis, ribonuclease protection assays, or RT-PCR.

T-24 Cells:

The human transitional cell bladder carcinoma cell line T-24 was obtained from the American Type Culture Collection (ATCC) (Manassas, Va.). T-24 cells were routinely cultured in complete McCoy's 5A basal media (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), penicillin 100 units per mL, and streptomycin 100 micrograms per mL (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence. Cells were seeded into 96-well plates (Falcon-Primaria #353872) at a density of 7000 cells/well for use in RT-PCR analysis.

For Northern blotting or other analysis, cells may be seeded onto 100 mm or other standard tissue culture plates and treated similarly, using appropriate volumes of medium and oligonucleotide.

A549 Cells:

The human lung carcinoma cell line A549 was obtained from the American Type Culture Collection (ATCC) (Manassas, Va.). A549 cells were routinely cultured in DMEM basal media (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), penicillin 100 units per mL, and streptomycin 100 micrograms per mL (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence.

NHDF Cells:

Human neonatal dermal fibroblast (NHDF) were obtained from the Clonetics Corporation (Walkersville, Md.). NHDFs were routinely maintained in Fibroblast Growth Medium (Clonetics Corporation, Walkersville, Md.) supplemented as recommended by the supplier. Cells were maintained for up to 10 passages as recommended by the supplier.

HEK Cells:

Human embryonic keratinocytes (HEK) were obtained from the Clonetics Corporation (Walkersville, Md.). HEKs were routinely maintained in Keratinocyte Growth Medium (Clonetics Corporation, Walkersville, Md.) formulated as recommended by the supplier. Cells were routinely maintained for up to 10 passages as recommended by the supplier.

Hep3B Cells:

The human hepatoma cell line Hep3B (Hep3B2.1-7) was obtained from the American Type Culture Collection (ATCC Catalog # HB-8064; Manassas, Va.). This cell line was initially derived from a hepatocellular carcinoma of an 8-yr-old black male. The cells are epithelial in morphology and are tumorigenic in nude mice. These cells can be induced to produce C-reactive protein by addition of media containing 1 μM dexamethasone (Sigma-Catalog #D2915 St. Louis, Mo.), 400 U/ml IL1B (Sigma-Catalog #19401) and 200 U/ml IL6 (Sigma-Catalog#1139), according to the protocol described by Lozanski, et al., (Cytokine, vol. 8, 1996 pp.534-540). Hep3B cells were routinely cultured in Minimum Essential Medium (MEM) with Earle's Balanced Salt Solution, 2 mM L-glutamine, 1.5 g/L sodium bicarbonate, 0.1 mM nonessential amino acids, 1.0 mM sodium pyruvate (ATCC #20-2003, Manassas, Va.) and with 10% heat-inactivated fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence.

In order to determine antisense oligonucleotide inhibition of induced C-reactive protein, Hep3B cells were plated at a density of 100,000 cells into each well of a 6 well plate (Primaria, Franklin N.J., Catalog# 3846) in MEM supplemented with 10% fetal bovine serum and allowed to attach overnight. The next day, cells were induced to produce C-reactive protein for 24 hours in regular media supplemented with a final concentration of 1 μM dexamethasone, 400 U/ml IL1B and 200 U/ml IL6 as described above. At the end of this induction period, the media was removed and cells treated for 4 hrs with 50-150 nM of antisense oligonucleotide and 3.0-4.5 μg LIPOFECTIN™ reagent in MEM alone (minus) serum supplemented with the three cytokines. At the end of the 4-hour drug treatment, the media was removed and fresh MEM containing FCS and cytokines was added to each well and allowed to sit for an additional 20 hrs. RNA was harvested 24 hrs after treatment with oligonucleotide using the QIAGEN® RNeasy (Qiagen Ltd, Valencia, Calif.) procedure and C-reactive protein RNA detected using RT-PCR analysis.

Primary Rat Hepatocytes:

Primary rat hepatocytes were prepared from Sprague-Dawley rats purchased from Charles River Labs (Wilmington, Mass.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were cultured to 80% confluence for use in antisense oligonucleotide transfection experiments.

Primary Rabbit Hepatocytes:

Primary rabbit hepatocytes from New Zealand White rabbits were purchased from InVitro Technologies (Baltimore, Md.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Primary rabbit hepatocytes are purchased and transfected at 100% confluency.

Primary Mouse Hepatocytes:

Primary mouse hepatocytes were prepared from Balb/c mice purchased from Charles River Labs (Wilmington, Mass.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were cultured to 80% confluence for use in antisense oligonucleotide transfection experiments.

Primary Human Hepatocytes:

Pre-plated primary human hepatocytes were purchased from InVitro Technologies (Baltimore, Md.). Cells were cultured in high-glucose DMEM (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units/mL penicillin and 100 μg/mL streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were transfected with oligonucleotide upon receipt from the vendor.

Primary Cynomolgus Monkey Hepatocytes:

Pre-plated primary Cynomolgus monkey hepatocytes were purchased from InVitro Technologies (Baltimore, Md.). Cells were cultured in high-glucose DMEM (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units/mL penicillin and 100 μg/mL streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were treated with oligonucleotide upon receipt from the vendor.

Treatment with Antisense Compounds:

When cells reached 65-75% confluency, they were treated with oligonucleotide. For cells grown in 96-well plates, wells were washed once with 100 μL OPTI-MEM™-1 reduced-serum medium or with serum-free DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) and then treated with 130 μL of OPTI-MEM™-1 medium containing 3.75 μg/mL LIPOFECTIN™ reagent (Invitrogen Corporation, Carlsbad, Calif.) and the desired concentration of oligonucleotide. Cells are treated and data are obtained in triplicate. After 4-7 hours of treatment at 37° C., the medium was replaced with fresh medium. Cells were harvested 16-24 hours after oligonucleotide treatment.

The concentration of oligonucleotide used varies from cell line to cell line. To determine the optimal oligonucleotide concentration for a particular cell line, the cells are treated with a positive control oligonucleotide at a range of concentrations. For human cells the positive control oligonucleotide is selected from either ISIS 13920 (TCCGTCATCGCTCCTCAGGG, SEQ ID NO: 1), which is targeted to human H-ras, or ISIS 18078, (GTGCGCGCGAGCCCGAAATC, SEQ ID NO: 2) which is targeted to human Jun-N-terminal kinase-2 (JNK2). Both controls are 2′-O-methoxyethyl gapmers (2′-O-methoxyethyls shown in bold) with a phosphorothioate backbone. For mouse or rat cells the positive control oligonucleotide is ISIS 15770, ATGCATTCTGCCCCCAAGGA, SEQ ID NO: 3, a 2′-O-methoxyethyl gapmer (2′-O-methoxyethyls shown in bold) with a phosphorothioate backbone which is targeted to both mouse and rat c-raf. The concentration of positive control oligonucleotide that results in 80% inhibition of c-H-ras (for ISIS 13920), JNK2 (for ISIS 18078) or c-raf (for ISIS 15770) mRNA is then utilized as the screening concentration for new oligonucleotides in subsequent experiments for that cell line. If 80% inhibition is not achieved, the lowest concentration of positive control oligonucleotide that results in 60% inhibition of c-H-ras, JNK2 or c-raf mRNA is then utilized as the oligonucleotide screening concentration in subsequent experiments for that cell line. If 60% inhibition is not achieved, that particular cell line is deemed as unsuitable for oligonucleotide transfection experiments. The concentrations of antisense oligonucleotides used herein are from 50 nM to 300 nM.

Example 10 Analysis of Oligonucleotide Inhibition of C-Reactive Protein Expression

Antisense modulation of C-reactive protein expression can be assayed in a variety of ways known in the art. For example, C-reactive protein mRNA levels can be quantitated by, e.g., Northern blot analysis, competitive polymerase chain reaction (PCR), or real-time PCR (RT-PCR). Real-time quantitative PCR is presently preferred. RNA analysis can be performed on total cellular RNA or poly(A)+ mRNA. The preferred method of RNA analysis of the present invention is the use of total cellular RNA as described in other examples herein. Methods of RNA isolation are well known in the art. Northern blot analysis is also routine in the art. Real-time quantitative (PCR) can be conveniently accomplished using the commercially available ABI PRISM™ 7600, 7700, or 7900 Sequence Detection System, available from PE-Applied Biosystems, Foster City, Calif. and used according to manufacturer's instructions.

Protein levels of C-reactive protein can be quantitated in a variety of ways well known in the art, such as immunoprecipitation, Western blot analysis (immunoblotting), enzyme-linked immunosorbent assay (ELISA) or fluorescence-activated cell sorting (FACS). Antibodies directed to C-reactive protein can be identified and obtained from a variety of sources, such as the MSRS catalog of antibodies (Aerie Corporation, Birmingham, Mich.), or can be prepared via conventional monoclonal or polyclonal antibody generation methods well known in the art.

Example 11 Design of Phenotypic Assays for the use of C-Reactive Protein Inhibitors

Once C-reactive protein inhibitors have been identified by the methods disclosed herein, the compounds are further investigated in one or more phenotypic assays, each having measurable endpoints predictive of efficacy in the treatment of a particular disease state or condition. Phenotypic assays, kits and reagents for their use are well known to those skilled in the art and are herein used to investigate the role and/or association of C-reactive protein in health and disease. Representative phenotypic assays, which can be purchased from any one of several commercial vendors, include those for determining cell viability, cytotoxicity, proliferation or cell survival (Molecular Probes, Eugene, Oreg.; PerkinElmer, Boston, Mass.), protein-based assays including enzymatic assays (Panvera, LLC, Madison, Wis.; BD Biosciences, Franklin Lakes, N.J.; Oncogene Research Products, San Diego, Calif.), cell regulation, signal transduction, inflammation, oxidative processes and apoptosis (Assay Designs Inc., Ann Arbor, Mich.), triglyceride accumulation (Sigma-Aldrich, St. Louis, Mo.), angiogenesis assays, tube formation assays, cytokine and hormone assays and metabolic assays (Chemicon International Inc., Temecula, Calif.; Amersham Biosciences, Piscataway, N.J.)

In one non-limiting example, cells determined to be appropriate for a particular phenotypic assay (i.e., MCF-7 cells selected for breast cancer studies; adipocytes for obesity studies) are treated with C-reactive protein inhibitors identified from the in vitro studies as well as control compounds at optimal concentrations which are determined by the methods described above. At the end of the treatment period, treated and untreated cells are analyzed by one or more methods specific for the assay to determine phenotypic outcomes and endpoints.

Phenotypic endpoints include changes in cell morphology over time or treatment dose as well as changes in levels of cellular components such as proteins, lipids, nucleic acids, hormones, saccharides or metals. Measurements of cellular status, which include pH, stage of the cell cycle, intake or excretion of biological indicators by the cell, are also endpoints of interest.

Analysis of the genotype of the cell (measurement of the expression of one or more of the genes of the cell) after treatment is also used as an indicator of the efficacy or potency of the C-reactive protein inhibitors. Hallmark genes, or those genes suspected to be associated with a specific disease state, condition, or phenotype, are measured in both treated and untreated cells.

The cells subjected to the phenotypic assays described herein derive from in vitro cultures or from tissues or fluids isolated from living organisms, both human and non-human. In certain embodiments, a tissue and its constituent cells comprise, but are not limited to, blood (e.g., hematopoietic cells, such as human hematopoietic progenitor cells, human hematopoietic stem cells, CD34⁺cells CD4⁺cells), lymphocytes and other blood lineage cells, bone marrow, brain, stem cells, blood vessel, liver, lung, bone, breast, cartilage, cervix, colon, cornea, embryonic, endometrium, endothelial, epithelial, esophagus, facia, fibroblast, follicular, ganglion cells, glial cells, goblet cells, kidney, lymph node, muscle, neuron, ovaries, pancreas, peripheral blood, prostate, skin, skin, small intestine, spleen, stomach, testes and fetal tissue. In other embodiments, a fluid and its constituent cells comprise, but are not limited to, blood, urine, synovial fluid, lymphatic fluid and cerebro-spinal fluid. The phenotypic assays may also be performed on tissues treated with C-reactive protein inhibitors ex vivo.

Example 12 RNA Isolation

Poly(A)+ mRNA Isolation

Poly(A)+ mRNA was isolated according to Miura et al., (Clin. Chem., 1996, 42, 1758-1764). Other methods for poly(A)+ mRNA isolation are routine in the art. Briefly, for cells grown on 96-well plates, growth medium was removed from the cells and each well was washed with 200 μL cold PBS. 60 μL lysis buffer (10 mM Tris-HCl, pH 7.6, 1 mM EDTA, 0.5 M NaCl, 0.5% NP-40, 20 mM vanadyl-ribonucleoside complex) was added to each well, the plate was gently agitated and then incubated at room temperature for five minutes. 55 μL of lysate was transferred to Oligo d(T) coated 96-well plates (AGCT Inc., Irvine Calif.). Plates were incubated for 60 minutes at room temperature, washed 3 times with 200 μL of wash buffer (10 mM Tris-HCl pH 7.6, 1 mM EDTA, 0.3 M NaCl). After the final wash, the plate was blotted on paper towels to remove excess wash buffer and then air-dried for 5 minutes. 60 μL of elution buffer (5 mM Tris-HCl pH 7.6), preheated to 70° C., was added to each well, the plate was incubated on a 90° C. hot plate for 5 minutes, and the eluate was then transferred to a fresh 96-well plate.

Cells grown on 100 mm or other standard plates may be treated similarly, using appropriate volumes of all solutions.

Total RNA Isolation

Total RNA was isolated using an RNEASY 96™ kit and buffers purchased from Qiagen Inc. (Valencia, Calif.) following the manufacturer's recommended procedures. Briefly, for cells grown on 96-well plates, growth medium was removed from the cells and each well was washed with 200 μL cold PBS. 150 μL Buffer RLT was added to each well and the plate vigorously agitated for 20 seconds. 150 μL of 70% ethanol was then added to each well and the contents mixed by pipetting three times up and down. The samples were then transferred to the RNEASY 96™ well plate attached to a QIAVAC™ manifold fitted with a waste collection tray and attached to a vacuum source. Vacuum was applied for 1 minute. 500 μL of Buffer RW1 was added to each well of the RNEASY 96™ plate and incubated for 15 minutes and the vacuum was again applied for 1 minute. An additional 500 μL of Buffer RW1 was added to each well of the RNEASY 96™ plate and the vacuum was applied for 2 minutes. 1 mL of Buffer RPE was then added to each well of the RNEASY 96™ plate and the vacuum applied for a period of 90 seconds. The Buffer RPE wash was then repeated and the vacuum was applied for an additional 3 minutes. The plate was then removed from the QIAVAC™ manifold and blotted dry on paper towels. The plate was then re-attached to the QIAVAC™ manifold fitted with a collection tube rack containing 1.2 mL collection tubes. RNA was then eluted by pipetting 140 μL of RNAse free water into each well, incubating 1 minute, and then applying the vacuum for 3 minutes.

The repetitive pipetting and elution steps may be automated using a QIAGEN® BIO-ROBOT™ 9604-(Qiagen, Inc., Valencia Calif.). Essentially, after lysing of the cells on the culture plate, the plate is transferred to the robot deck where the pipetting, DNase treatment and elution steps are carried out.

Example 13 Real-Time Quantitative PCR Analysis of C-Reactive Protein mRNA Levels

Quantitation of C-reactive protein mRNA levels was accomplished by real-time quantitative PCR using the ABI PRISM™ 7600, 7700, or 7900 Sequence Detection System (PE-Applied Biosystems, Foster City, Calif.) according to manufacturer's instructions. This is a closed-tube, non-gel-based, fluorescence detection system which allows high-throughput quantitation of polymerase chain reaction (PCR) products in real-time. As opposed to standard PCR in which amplification products are quantitated after the PCR is completed, products in real-time quantitative PCR are quantitated as they accumulate. This is accomplished by including in the PCR reaction an oligonucleotide probe that anneals specifically between the forward and reverse PCR primers, and contains two fluorescent dyes. A reporter dye (e.g., FAM or JOE, obtained from either PE-Applied Biosystems, Foster City, Calif., Operon Technologies Inc., Alameda, Calif. or Integrated DNA Technologies Inc., Coralville, Iowa) is attached to the 5′ end of the probe and a quencher dye (e.g., TAMRA, obtained from either PE-Applied Biosystems, Foster City, Calif., Operon Technologies Inc., Alameda, Calif. or Integrated DNA Technologies Inc., Coralville, Iowa) is attached to the 3′ end of the probe. When the probe and dyes are intact, reporter dye emission is quenched by the proximity of the 3′ quencher dye. During amplification, annealing of the probe to the target sequence creates a substrate that can be cleaved by the 5′-exonuclease activity of Taq polymerase. During the extension phase of the PCR amplification cycle, cleavage of the probe by Taq polymerase releases the reporter dye from the remainder of the probe (and hence from the quencher moiety) and a sequence-specific fluorescent signal is generated. With each cycle, additional reporter dye molecules are cleaved from their respective probes, and the fluorescence intensity is monitored at regular intervals by laser optics built into the ABI PRISM™ Sequence Detection System. In each assay, a series of parallel reactions containing serial dilutions of mRNA from untreated control samples generates a standard curve that is used to quantitate the percent inhibition after antisense oligonucleotide treatment of test samples.

Prior to quantitative PCR analysis, primer-probe sets specific to the target gene being measured are evaluated for their ability to be “multiplexed” with a GAPDH amplification reaction. In multiplexing, both the target gene and the internal standard gene GAPDH are amplified concurrently in a single sample. In this analysis, mRNA isolated from untreated cells is serially diluted. Each dilution is amplified in the presence of primer-probe sets specific for GAPDH only, target gene only (“single-plexing”), or both (multiplexing). Following PCR amplification, standard curves of GAPDH and target mRNA signal as a function of dilution are generated from both the single-plexed and multiplexed samples. If both the slope and correlation coefficient of the GAPDH and target signals generated from the multiplexed samples fall within 10% of their corresponding values generated from the single-plexed samples, the primer-probe set specific for that target is deemed multiplexable. Other methods of PCR are also known in the art.

Gene target quantities are obtained by reverse-transcriptase, real-time PCR. Prior to the real-time PCR, isolated RNA is subjected to a reverse transcriptase (RT) reaction, for the purpose of generating complementary DNA (cDNA). Reverse transcriptase and real-time PCR reagents were obtained from Invitrogen Corporation, (Carlsbad, Calif.). RT, real-time PCR reactions were carried out by adding 20 μL PCR cocktail (2.5× PCR buffer minus MgCl₂, 6.6 mM MgCl₂, 375 μM each of dATP, dCTP, dCTP and dGTP, 375 nM each of forward primer and reverse primer, 125 nM of probe, 4 Units RNAse inhibitor, 1.25 Units PLATINUM® Taq, 5 Units MuLV reverse transcriptase, and 2.5×ROX dye) to 96-well plates containing 30 μL total RNA solution (20-200 ng). The RT reaction was carried out by incubation for 30 minutes at 48° C. Following a 10 minute incubation at 95° C. to activate the PLATINUM® Taq, 40 cycles of a two-step PCR protocol were carried out: 95° C. for 15 seconds (denaturation) followed by 60° C. for 1.5 minutes (annealing/extension). This method of obtaining gene target quantities is herein referred to as real-time PCR.

Gene target quantities obtained by real-time PCR are normalized using either the expression level of GAPDH, a gene whose expression is constant, or by quantifying total RNA using RiboGreen reagent (Molecular Probes, Inc. Eugene, Oreg.). GAPDH expression is quantified by real-time PCR by being run simultaneously with the target, multiplexing, or separately. Total RNA is quantified using RiboGreen™ RNA quantification reagent (Molecular Probes, Inc. Eugene, Oreg.). Methods of RNA quantification by RiboGreen reagent are taught in Jones, L. J., et al, (Analytical Biochemistry, 1998, 265, 368-374).

In this assay, 170 μL of RiboGreen™ working reagent (RiboGreen™ reagent diluted 1:350 in 10 mM Tris-HCl, 1 mM EDTA, pH 7.5) is pipetted into a 96-well plate containing 30 μL purified, cellular RNA. The plate is read in a CytoFluor 4000 reader (PE Applied Biosystems) with excitation at 485 nm and emission at 530 nm.

Probes and primers to human C-reactive protein were designed to hybridize to a human C-reactive protein sequence, using published sequence information (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). For human C-reactive protein the PCR primers were: forward primer: TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 5) reverse primer: TCCGACTCTTTGGGAAACACA (SEQ ID NO: 6) and the PCR probe was: FAM-TGTCGAGGAAGGCTT-TAMRA (SEQ ID NO: 7) where FAM is the fluorescent dye and TAMRA is the quencher dye. For human GAPDH the PCR primers were: forward primer: GAAGGTGAAGGTCGGAGTC(SEQ ID NO: 8) reverse primer: GAAGATGGTGATGGGATTTC (SEQ ID NO: 9) and the PCR probe was: 5′ JOE-CAAGCTTCCCGTTCTCAGCC-TAMRA 3′ (SEQ ID NO: 10) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye.

Probes and primers to rat C-reactive protein were designed to hybridize to a rat C-reactive protein sequence, using published sequence information (GENBANK® accession number M83176.1, incorporated herein as SEQ ID NO: 11). For rat C-reactive protein the PCR primers were: forward primer: AAGCACCCCCAATGTCACC (SEQ ID NO: 12) reverse primer: GGGATGGCAGAGCCAATGTA (SEQ ID NO: 13) and the PCR probe was: FAM-TCCTGGATTCAAGCTTCTATGTGCCTTCA-TAMRA (SEQ ID NO: 14) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For rat GAPDH the PCR primers were: forward primer: TGTTCTAGAGACAGCCGCATCTT(SEQ ID NO: 15) reverse primer: CACCGACCTTCACCATCTTGT(SEQ ID NO: 16) and the PCR probe was: 5′ JOE-TTGTGCAGTGCCAGCCTCGTCTCA-TAMRA 3′ (SEQ ID NO: 17) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye.

Example 14 Northern Blot Analysis of C-Reactive Protein mRNA Levels

Eighteen hours after antisense treatment, cell monolayers were washed twice with cold PBS and lysed in 1 mL RNAZOL™ reagent (TEL-TEST “B” Inc., Friendswood, Tex.). Total RNA was prepared following manufacturer's recommended protocols. Twenty micrograms of total RNA was fractionated by electrophoresis through 1.2% agarose gels containing 1.1% formaldehyde using a MOPS buffer system (AMRESCO, Inc. Solon, Ohio). RNA was transferred from the gel to HYBOND™-N+ nylon membranes (Amersham Pharmacia Biotech, Piscataway, N.J.) by overnight capillary transfer using a Northern/Southern Transfer buffer system (TEL-TEST “B” Inc., Friendswood, Tex.). RNA transfer was confirmed by UV visualization. Membranes were fixed by UV cross-linking using a STRATALINKER™ UV Crosslinker 2400 instrument (Stratagene, Inc, La Jolla, Calif.) and then probed using QUICKHYB™ hybridization solution (Stratagene, La Jolla, Calif.) using manufacturer's recommendations for stringent conditions.

To detect human C-reactive protein, a human C-reactive protein specific probe was prepared by PCR using the forward primer TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 5) and the reverse primer TCCGACTCTTTGGGAAACACA (SEQ ID NO: 6). To normalize for variations in loading and transfer efficiency membranes were stripped and probed for human glyceraldehyde-3-phosphate dehydrogenase (GAPDH) RNA (Clontech, Palo Alto, Calif.).

To detect rat C-reactive protein, a rat C-reactive protein specific probe was prepared by PCR using the forward primer TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 12) and the reverse primer TCCGACTCTTTGGGAAACACA (SEQ ID NO: 13). To normalize for variations in loading and transfer efficiency membranes were stripped and probed for rat glyceraldehyde-3-phosphate dehydrogenase (GAPDH) RNA (Clontech, Palo Alto, Calif.).

Hybridized membranes were visualized and quantitated using a PHOSPHORIMAGER™ apparatus and IMAGEQUANT™ Software V3.3 (Molecular Dynamics, Sunnyvale, Calif.). Data was normalized to GAPDH levels in untreated controls.

Example 15 Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap

In accordance with the present invention, a series of antisense compounds was designed to target different regions of the human C-reactive protein RNA, using published sequences (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 1. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 1 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines. The compounds were analyzed for their effect on human C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Data, shown in Table 1, are averages from three experiments in which cytokine-induced Hep3B cells were treated with 150 nM of the antisense oligonucleotides of the present invention. The positive control for each data point is identified in the table by sequence ID number. If present, “N.D.” indicates “no data”.

TABLE 1 Inhibition of human C-reactive protein mRNA levels by chimeric phosphorothioate oligonucleotides having 2′-MOE wings and a deoxy gap TARGET ISIS SEQ ID TARGET % SEQ # REGION NO SITE SEQUENCE INHIB ID NO 133709 5′UTR 4 16 gcaggtgtcagagcttcggg 77 19 133710 5′UTR 4 71 gcagtaagggagtttgcgcc 71 20 133711 5′UTR 4 181 gcctgaattcactcctttgg 87 21 133712 Start Codon 4 221 agcttctccatggtcacgtc 92 22 133713 Coding 4 281 tggcccttacctgtctggcc 88 23 133714 Intron 4 311 ctcagatcaaaactctccca 30 24 133715 Intron 4 341 ttcatgcagtcttagacccc N.D. 25 133716 Coding 4 551 gtctgtgagccagaaaaaca 77 26 133717 Coding 4 701 cgagaaaatactgtacccac 82 27 133718 Coding 4 781 gacccacccactgtaaaact 82 28 133719 Coding 4 871 cagaactccacgatccctga 96 29 133720 Coding 4 1091 attaggactgaagggcccgc 86 30 133721 Stop Codon 4 1171 agctggcctcagggccacag 80 31 133722 3′UTR 4 1191 gaggtaccttcaggacccac 89 32 133723 3′UTR 4 1361 cccagaccagacactttacc 88 33 133724 3′UTR 4 1391 tggaccatttcccagcatag 67 34 133725 3′UTR 4 1631 ttctgagactgaagagccct 27 35 133726 3′UTR 4 1671 gcactctggacccaaaccag 96 36 133727 3′UTR 4 1711 caggagacctgggcccagca 85 37 133728 3′UTR 4 1918 cccagaagagccataaaatt 27 38 133729 3′UTR 4 1961 attcacagccccacaaggtt 90 39 133730 3′UTR 4 2161 agaagatgtctcactcccaa 91 40 133731 3′UTR 4 2291 tgtttgtcaatcccttggct 93 41 133732 3′UTR 4 2431 ttctaaagcaactatcagaa 64 42 140167 5′UTR 4 111 gccttagagctacctcctcc 70 43 140168 5′UTR 4 201 ctgctgccagtgatacaagg 69 44 140169 Intron 4 317 ccatacctcagatcaaaact 48 45 140170 Intron 4 451 accccttctccagttacaca 69 46 140171 Coding 4 671 cagttccgtgtagaagtgga 43 47 140172 Coding 4 761 gtatcctatatccttagacc N.D. 48 140173 Coding 4 821 tggagctactgtgacttcag 82 49 140174 Coding 4 861 cgatccctgaggcggactcc N.D. 50 140175 Coding 4 901 ctcttcctcaccctgggctt 84 51 140176 Coding 4 921 cagtgtatcccttcttcaga 68 52 140177 Coding 4 951 gccccaagatgatgcttgct 95 53 140178 Coding 4 1031 gtcccacatgttcacatttc 61 54 140179 Coding 4 1111 agtgcccgccagttcaggac 86 55 140180 Coding 4 1141 gtgaacacttcgccttgcac 94 56 140181 3′UTR 4 1341 tccattctcaggcgctgagg 85 57 140182 3′UTR 4 1461 gaaattatctccaagatctg 33 58 140183 3′UTR 4 1551 cagcgcttccttctcagctc 94 59 140184 3′UTR 4 1611 gtgaatgtgggcaatgctcc 58 60 140185 3′UTR 4 1651 acacctgqccagtgtcctga N.D. 61 140186 3′UTR 4 1771 cctttccagtgtgctttgag N.D. 62 140187 3′UTR 4 1831 tagtgcttcattttgctctg 93 63 140188 3′UTR 4 1971 tgaagaaaqaattcacagcc 58 64 140189 3′UTR 4 2041 ggctcctctgacaggacacc 86 65 140190 3′UTR 4 2101 gctaggaacacgtaactatc 71 66 140191 3′UTR 4 2121 ggaagactgtagttggtcct 35 67 140192 3′UTR 4 2211 ctactggtggtcccaggttc 77 68 140193 3′UTR 4 2271 cctccacttccagtttggct 77 69 140194 3′UTR 4 2341 ctggttccagacaaggctga 92 70 140195 3′UTR 4 2402 gactcactcaagtaaacagg 71 71 140196 3′UTR 4 2461 ttcaaaggtcatagagaagt 28 72

As shown in Table 1, SEQ ID NOs 19, 20, 21, 22, 23, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 36, 37, 39, 40, 41, 42, 43, 44, 46, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 59, 60, 61, 62, 63, 64, 65, 66, 68, 69, 70 and 71 demonstrated at least 50% inhibition of human C-reactive protein expression in this assay and are therefore preferred. More preferred are SEQ ID NOs 36, 22 and 56. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Table 1. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.

In further embodiment of the present invention, a second series of antisense compounds was designed to target different regions of the human C-reactive protein RNA, using published sequences (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 2. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 2 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

The compounds were analyzed for their effect on human C-reactive protein mRNA levels by quantitative real-time PCR using a second set of probes and primer designed to hybridize to a human C-reactive protein sequence, using published sequence information (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). For human C-reactive protein the PCR primers were: forward primer: GCTTCCCCTCTTCCCGAA (SEQ ID NO: 73) reverse primer: TGCGCCACTATGTAAATAATTTTCC (SEQ ID NO: 74) and the PCR probe was: FAM-TCTGACACCTGCCCCAACAAGCAATG-TAMRA (SEQ ID NO: 75) where FAM is the fluorescent dye and TAMRA is the quencher dye. Data, shown in Table 2, are averages from three experiments in which cytokine-induced Hep3B cells were treated with 150 nM of the antisense oligonucleotides of the present invention. The positive control for each datapoint is identified in the table by sequence ID number. If present, “N.D.” indicates “no data”.

TABLE 2 Inhibition of human C-reactive protein mRNA levels by chimeric phosphorothioate oligonucleotides having 2′-MOE wings and a deoxy gap TARGET CONTROL ISIS SEQ ID TARGET % SEQ ID SEQ ID # REGION NO SITE SEQUENCE INHIB NO NO 140185 3′UTR 4 1651 acacctggccagtgtcctga 37 61 1 140186 3′UTR 4 1771 cctttccagtgtgctttgag 1 62 1 329883 3′UTR 4 10 gtcagagcttcgggaagagg 6 76 1 329884 3′UTR 4 37 tttccaacattgcttgttgg 0 77 1 329885 3′UTR 4 47 tgtaaataattttccaacat 41 78 1 329886 3′UTR 4 57 tgcgccactatgtaaataat 7 79 1 329887 3′UTR 4 67 taagggagtttgcgccacta 40 80 1 329888 3′UTR 4 77 tccaaagcagtaagggagtt 21 81 1 329889 3′UTR 4 87 tggatttatatccaaagcag N.D. 82 329890 3′UTR 4 94 tcctgcctggatttatatcc 8 83 1 329891 3′UTR 4 107 tagagctacctcctcctgcc 1 84 1 329892 3′UTR 4 122 ccagatctcttgccttagag 70 85 1 329893 3′UTR 4 132 gctagaagtcccagatctct 38 86 1 329894 3′UTR 4 157 gatgtattcggctgaaagtt 29 87 1 329895 3′UTR 4 167 ctttggaaaagatgtattcg 22 88 1 329896 3′UTR 4 191 tgatacaagggcctgaattc 30 89 1 329897 Start codon 4 206 acgtcctgctgccagtgata 44 90 1 329898 Coding 4 226 acaacagcttctccatggtc 43 91 1 329899 Coding 4 231 gaaacacaacagcttctcca 28 92 1 329900 Coding 4 241 tcaagaccaagaaacacaac 0 93 1 329901 Coding 4 251 gagaggctggtcaagaccaa 15 94 1 329902 Coding 4 258 agcatgagagaggctggtca 54 95 1 329903 Coding 4 268 tctggccaaaagcatgagag 48 96 1 329904 Coding 4 278 cccttacctgtctggccaaa 45 97 1 329905 Coding 4 283 ggtggcccttacctgtctgg 12 98 1 329906 Coding 4 318 cccatacctcagatcaaaac 0 99 1 329907 Coding 4 342 gttcatgcagtcttagaccc 21 100 1 329908 Coding 4 347 agactgttcatgcagtctta N.D. 101 329909 Coding 4 351 tttgagactgttcatgcagt 28 102 1 329910 Coding 4 381 gttctgttcatacagtcttt 16 103 1 329911 Coding 4 386 ccactgttctgttcatacag 0 104 1 329912 Coding 4 391 atgctccactgttctgttca 4 105 1 329913 Coding 4 396 gaaggatgctccactgttct 0 106 1 329914 Coding 4 401 accatgaaggatgctccact 49 107 1 329915 Coding 4 406 cacacaccatgaaggatgct 33 108 1 329916 Coding 4 411 acacacacacaccatgaagg 0 109 1 329917 Coding 4 449 cccttctccagttacacacc 3 110 1 329918 Coding 4 459 acagactgaccccttctcca 19 111 1 329919 Coding 4 469 agattgagaaacagactgac 52 112 1 329920 Coding 4 479 atagaatttaagattgagaa 8 113 1 329921 Coding 4 489 tcacttacgtatagaattta 0 114 1 329922 Coding 4 492 ccctcacttacgtatagaat 40 115 1 329923 Coding 4 499 atctatcccctcacttacgt 23 116 1 329924 Coding 4 510 agatcacacagatctatccc 6 117 1 329925 Coding 4 520 gaggtttctcagatcacaca 0 118 1 329926 Coding 4 530 gcaaatgtgagaggtttctc 4 119 1 329927 Coding 4 557 cgacatgtctgtgagccaga 39 120 1 329928 Coding 4 562 ttcctcgacatgtctgtgag 52 121 1 329929 Coding 4 567 aagccttcctcgacatgtct 81 122 1 329930 Coding 4 596 ggaagtatccgactctttgg 39 123 1 329931 Coding 4 605 ggatacataggaagtatccg 0 124 1 329932 Coding 4 615 gtgctttgagggatacatag 12 125 1 329933 Coding 4 625 ttcgttaacggtgctttgag 0 126 1 329934 Coding 4 635 tttgagaggcttcgttaacg 0 127 1 329935 Coding 4 645 cagtgaaggctttgagaggc 1 128 1 329936 Coding 4 655 tggaggcacacagtgaaggc 69 129 1 329937 Coding 4 660 agaagtggaggcacacagtg 0 130 1 329938 Coding 4 665 cgtgtagaagtggaggcaca 36 131 1 329939 Coding 4 675 aggacagttccgtgtagaag 40 132 1 329940 Coding 4 685 ccacgggtcgaggacagttc 46 133 1 329941 Coding 4 695 aatactgtacccacgggtcg 26 134 1 329942 Coding 4 716 tctcttggtggcatacgaga 55 135 1 329943 Coding 4 726 cattgtcttgtctcttggtg 70 136 1 329944 Coding 4 736 atgagaatctcattgtcttg 58 137 1 329945 Coding 4 746 agaccaaaatatgagaatct 6 138 1 329946 Coding 4 756 ctatatccttagaccaaaat 26 139 1 329947 Coding 4 765 aactgtatcctatatcctta 0 140 1 329948 Coding 4 775 cccactgtaaaactgtatcc 26 141 1 329949 Coding 4 785 ttcagacccacccactgtaa N.D. 142 329950 Coding 4 796 tcgaataatatttcagaccc 37 143 1 329951 Coding 4 806 ttcaggaacctcgaataata 14 144 1 329952 Coding 4 816 ctactgtgacttcaggaacc 59 145 1 329953 Coding 4 826 tgtactggagctactgtgac 39 146 1 329954 Coding 4 836 tgtacaaatgtgtactggag 60 147 1 329955 Coding 4 846 actcccagcttgtacaaatg 21 148 1 329956 Coding 4 856 cctgaggcggactcccagct 62 149 1 329957 Coding 4 860 gatccctgaggcggactccc 66 150 1 329958 Coding 4 870 agaactccacgatccctgag 30 151 1 329959 Coding 4 880 ccatctacccagaactccac 22 152 1 329960 Coding 4 890 cctgggcttcccatctaccc 34 153 1 329961 Coding 4 900 tcttcctcaccctgggcttc 52 154 1 329962 Coding 4 910 ttcttcagactcttcctcac 38 155 1 329963 Coding 4 920 agtgtatcccttcttcagac 39 156 1 329964 Coding 4 944 gatgatgcttgcttctgccc 55 157 1 329965 Coding 4 964 gaatcctgctcctgccccaa 37 158 1 329966 Coding 4 967 aaggaatcctgctcctgccc 55 159 1 329967 Coding 4 977 gttcccaccgaaggaatcct 26 160 1 329968 Coding 4 987 ttccttcaaagttcccaccg 59 161 1 329969 Coding 4 1000 accagggactggcttccttc 71 162 1 329970 Coding 4 1010 aatgtctcccaccagggact 7 163 1 329971 Coding 4 1020 tcacatttccaatgtctccc 56 164 1 329972 Coding 4 1030 tcccacatgttcacatttcc 49 165 1 329973 Coding 4 1040 cagcacaaagtcccacatgt 66 166 1 329974 Coding 4 1050 catctggtgacagcacaaag 65 167 1 329975 Coding 4 1060 gtgttaatctcatctggtga 47 168 1 329976 Coding 4 1070 aagatagatggtgttaatct 37 169 1 329977 Coding 4 1097 caggacattaggactgaagg 53 170 1 329978 Coding 4 1107 cccgccagttcaggacatta 52 171 1 329979 Coding 4 1117 tacttcagtgcccgccagtt 49 172 1 329980 Coding 4 1127 ttgcacttcatacttcagtg 69 173 1 329981 Coding 4 1137 acacttcgccttgcacttca 54 174 1 329982 Coding 4 1147 ggtttggtgaacacttcgcc 55 175 1 329983 3′UTR 4 1193 gggaggtaccttcaggaccc 48 176 1 329984 3′UTR 4 1235 taccagagacagagacgtgg 62 177 1 329985 3′UTR 4 1245 aagcgggaggtaccagagac 62 178 1 329986 3′UTR 4 1283 gcccagagacagagacgtgg 68 179 1 329987 3′UTR 4 1293 gggaacaaaggcccagagac 59 180 1 329988 3′UTR 4 1326 tgaggagggtggagcaggcc 44 181 1 329989 3′UTR 4 1338 attctcaggcgctgaggagg 44 182 1 329990 3′UTR 4 1348 ctttacctccattctcaggc 74 183 1 329991 3′UTR 4 1358 agaccagacactttacctcc 29 184 1 329992 3′UTR 4 1368 acgagctcccagaccagaca 70 185 1 329993 3′UTR 4 1378 agcatagttaacgagctccc 64 186 1 329994 3′UTR 4 1388 accatttcccagcatagtta 34 187 1 329995 3′UTR 4 1398 attcttttggaccatttccc 35 188 1 329996 3′UTR 4 1408 tcaaattctgattcttttgg 27 189 1 329997 3′UTR 4 1451 ccaagatctgtccaacttga 55 190 1 329998 3′UTR 4 1471 tgtgaggtaagaaattatct 21 191 1 329999 3′UTR 4 1481 ttctcatctatgtgaggtaa 74 192 1 330000 3′UTR 4 1491 ggtgttagttttctcatcta 63 193 1 330001 3′UTR 4 1501 ctcctttctgggtgttagtt 70 194 1 330002 3′UTR 4 1511 aacatcatttctcctttctg 41 195 1 330003 3′UTR 4 1536 agctcttgccttatgagttt 58 196 1 330004 3′UTR 4 1546 cttccttctcagctcttgcc 57 197 1 330005 3′UTR 4 1556 aagatcagcgcttccttctc 69 198 1 330006 3′UTR 4 1566 aattaaatagaagatcagcg 57 199 1 330007 3′UTR 4 1621 gaagagccctgtgaatgtgg 24 200 1 330008 3′UTR 4 1641 agtgtcctgattctgagact 53 201 1 330009 3′UTR 4 1661 cccaaaccagacacctggcc 75 202 1 330010 3′UTR 4 1681 atgatgatgagcactctgga 59 203 1 330011 3′UTR 4 1691 gttctatgacatgatgatga 59 204 1 330012 3′UTR 4 1719 tcccatttcaggagacctgg 60 205 1 330013 3′UTR 4 1729 ttgctgggcttcccatttca 39 206 1 330014 3′UTR 4 1739 ctgcgtggtattgctgggct 64 207 1 330015 3′UTR 4 1749 agtggagggactgcgtggta 60 208 1 330016 3′UTR 4 1761 gtgctttgagaaagtggagg 69 209 1 330017 3′UTR 4 1781 attctaatggcctttccagt 61 210 1 330018 3′UTR 4 1805 aagcagatctgctctgctgg 52 211 1 330019 3′UTR 4 1840 atttatacctagtgcttcat 53 212 1 330020 3′UTR 4 1850 gtaacaacatatttatacct 15 213 1 330021 3′UTR 4 1860 gttcttggcagtaacaacat 74 214 1 330022 3′UTR 4 1870 agtcatttaagttcttggca 67 215 1 330023 3′UTR 4 1923 agtttcccagaagagccata 45 216 1 330024 3′UTR 4 1952 cccacaaggttcgtgtggaa 53 217 1 330025 3′UTR 4 1962 aattcacagccccacaaggt 2 218 1 330026 3′UTR 4 1972 atgaagaaagaattcacagc 29 219 1 330027 3′UTR 4 2003 cttgtggcctgggtatattg 59 220 1 330028 3′UTR 4 2013 cacgtccactcttgtggcct 69 221 1 330029 3′UTR 4 2023 ccctgtggttcacgtccact 63 222 1 330030 3′UTR 4 2033 tgacaggacaccctgtggtt 29 223 1 330031 3′UTR 4 2043 tgggctcctctgacaggaca 66 224 1 330032 3′UTR 4 2043 tcctccagatagggagctgg N.D. 225 330033 3′UTR 4 2085 tatccaactatcctccagat 31 226 1 330034 3′UTR 4 2095 aacacgtaactatccaacta 27 227 1 330035 3′UTR 4 2105 tcctgctaggaacacgtaac 72 228 1 330036 3′UTR 4 2115 ctgtagttggtcctgctagg 56 229 1 330037 3′UTR 4 2126 ccttgggaagactgtagttg 34 230 1 330038 3′UTR 4 2136 ataactcaatccttgggaag 27 231 1 330039 3′UTR 4 2146 cccaaagtccataactcaat 22 232 1 330040 3′UTR 4 2156 atgtctcactcccaaagtcc 36 233 1 330041 3′UTR 4 2166 cagcaagaagatgtctcact 50 234 1 330042 3′UTR 4 2176 ggaaatccagcagcaagaag 48 235 1 330043 3′UTR 4 2186 ctctcagcttggaaatccag 57 236 1 330044 3′UTR 4 2196 ggttcacgtcctctcagctt 76 237 1 330045 3′UTR 4 2205 gtggtcccaggttcacgtcc 50 238 1 330046 3′UTR 4 2215 atggctactggtggtcccag N.D. 239 330047 3′UTR 4 2225 ggcaaacaagatggctactg 56 240 1 330048 3′UTR 4 2235 ctctccatgtggcaaacaag 53 241 1 330049 3′UTR 4 2245 ctcacagtctctctccatgt 58 242 1 330050 3′UTR 4 2255 ggcttctgtcctcacagtct 50 243 1 330051 3′UTR 4 2265 cttccagtttggcttctgtc 65 244 1 330052 3′UTR 4 2275 ggctcctccacttccagttt 71 245 1 330053 3′UTR 4 2285 tcaatcccttggctcctcca 53 246 1 330054 3′UTR 4 2295 ctgttgtttgtcaatccctt 61 247 1 330055 3′UTR 4 2305 ggtcaaggctctgttgtttg 30 248 1 330056 3′UTR 4 2315 gactccacgtggtcaaggct 79 249 1 330057 3′UTR 4 2325 ctgattcagagactccacgt 69 250 1 330058 3′UTR 4 2335 ccagacaaggctgattcaga 45 251 1 330059 3′UTR 4 2345 agatctggttccagacaagg 59 252 1 330060 3′UTR 4 2355 gtccaggtgtagatctggtt 53 253 1 330061 3′UTR 4 2365 gacctgggcagtccaggtgt 38 254 1 330062 3′UTR 4 2378 ttattggcttatagacctgg 56 255 1 330063 3′UTR 4 2410 acagcttggactcactcaag 30 256 1 330064 3′UTR 4 2432 cttctaaagcaactatcaga 10 257 1 330065 3′UTR 4 2442 ttagtcacaacttctaaagc 13 258 1 330066 3′UTR 4 2452 catagagaagttagtcacaa 22 259 1

As shown in Table 2, SEQ ID NOs 85, 95, 112, 121, 122, 129, 135, 136, 137, 145, 147, 149, 150, 154, 157, 159, 161, 162, 164, 166, 167, 170, 171, 173, 174, 175, 177, 178, 179, 180, 183, 185, 186, 190, 192, 193, 194, 196, 197, 198, 199, 201, 202, 203, 204, 205, 207, 208, 209, 210, 211, 212, 214, 215, 217, 220, 221, 222, 224, 228, 229, 234, 236, 237, 238, 240, 241, 242, 243, 244, 245, 246, 247, 249, 250, 252, 253 and 255 demonstrated at least 50% inhibition of human C-reactive protein expression in this assay and are therefore preferred. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Table 2. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.

Example 16 Antisense Inhibition of rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.

In accordance with the present invention, a series of antisense compounds was designed to target different regions of the rat C-reactive protein RNA, using published sequences (GENBANK® accession number M83176.1, incorporated herein as SEQ ID NO: 11). The compounds are shown in Table 3. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 3 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines. The compounds were analyzed for their effect on rat C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Data, shown in Table 3, are averages from three experiments in which primary rat hepatocytes were treated with 150 nM of the antisense oligonucleotides of the present invention. If present, “N.D.” indicates “no data”.

TABLE 3 Inhibition of rat C-reactive protein mRNA levels by chimeric phosphorothioate oligonucleotides having 2′-MOE wings and a deoxy gap TARGET ISIS SEQ ID TARGET % SEQ # REGION NO SITE SEQUENCE INHIB ID NO 197163 Start Codon 11 1 caccatagtagcttctccat 26 260 197164 Coding 11 21 agcttatcgtgatcagaaga 27 261 197165 Coding 11 41 atgaccaaaagcctgagaga 26 262 197166 Coding 11 61 gcctgtttagacatgtcttc 57 263 197167 Coding 11 81 acactccgggaaatacgaag 47 264 197168 Coding 11 101 ggacacataggcagtagctg 61 265 197169 Coding 11 121 ttctttgactctgcttccag 36 266 197170 Coding 11 141 cagtgaaggcttccagtggc 56 267 197171 Coding 11 161 agcgtgggcatagagacaca 48 268 197172 Coding 11 181 ctgaagcttcggctcacatc 23 269 197173 Coding 11 201 tggtagcgtaagagaagatg 26 270 197174 Coding 11 221 aatctcgttaaagctcgtct 34 271 197175 Coding 11 261 ctgcaatactaaacccttga 38 272 197176 Coding 11 281 cagtatttcaggcccaccta 39 273 197177 Coding 11 301 ggaatttctgaagcactgaa 30 274 197178 Coding 11 320 gatgtgtgttggtacctcag 21 275 197179 Coding 11 411 caatgtagcccttctgcaga 48 276 197180 Coding 11 431 gatgcttgcatttgtcccca 51 277 197181 Coding 11 451 tcctgctcctgccccaagat 19 278 197182 Coding 11 471 caaagccaccgccatacgag 28 279 197183 Coding 11 491 caccaaagactgattcgcgt 14 280 197184 Coding 11 511 ttcacatctccaatgtctcc 35 281 197185 Coding 11 531 atagcacaaagtcccacatg 53 282 197186 Coding 11 551 tgcattgatctgttctggag 37 283 197187 Coding 11 571 aataccctaccaacatagac 47 284 197188 Coding 11 601 agtgcccgccagttcaaaac 40 285 197189 Coding 11 621 caccgtgtgtttcatacttc 31 286 197190 Coding 11 641 ctgcggcttgataaacacat 21 287 197191 Coding 11 661 cagtcagtcaagggccacag 43 288 197192 Coding 11 671 ggactcacaacagtcagtca 35 289

As shown in Table 3, SEQ ID NOs 260, 261, 262, 263, 264, 265, 266, 267, 268, 270, 271, 272, 273, 274, 276, 277, 279, 281, 282, 283, 284, 285, 286, 288 and 289 demonstrated at least 25% inhibition of rat C-reactive protein expression in this experiment and are therefore preferred. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Tables 1,2 and 3. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.

TABLE 4 Sequence and position of preferred target segments identified in C-reactive protein. TARGET REV SITE SEQ ID TARGET COMP OF SEQ ID NO SITE SEQUENCE SEQ ID ACTIVE IN ID NO 44586 11 16 cccgaagctctgacacctgc 19 H. sapiens 290 44587 11 71 ggcgcaaactcccttactgc 20 H. sapiens 291 44588 11 181 ccaaaggagtgaattcaggc 21 H. sapiens 292 44589 11 221 gacgtgaccatggagaagct 22 H. sapiens 293 44590 11 281 ggccagacaggtaagggcca 23 H. sapiens 294 44592 11 341 ggggtctaagactgcatgaa 25 H. sapiens 295 44593 11 551 tgtttttctggctcacagac 26 H. sapiens 296 44594 11 701 gtgggtacagtattttctcg 27 H. sapiens 297 44595 11 781 agttttacagtgggtgggtc 28 H. sapiens 298 44596 11 871 tcagggatcgtggagttctg 29 H. sapiens 299 44597 11 1091 gcgggcccttcagtcctaat 30 H. sapiens 300 44598 11 1171 ctgtggccctgaggccagct 31 H. sapiens 301 44599 11 1191 gtgggtcctgaaggtacctc 32 H. sapiens 302 44600 11 1361 ggtaaagtgtctggtctggg 33 H. sapiens 303 44601 11 1391 ctatgctgggaaatggtcca 34 H. sapiens 304 44603 11 1671 ctggtttgggtccagagtgc 36 H. sapiens 305 44604 11 1711 tgctgggcccaggtctcctg 37 H. sapiens 306 44606 11 1961 aaccttgtggggctgtgaat 39 H. sapiens 307 44607 11 2161 ttgggagtgagacatcttct 40 H. sapiens 308 44608 11 2291 agccaagggattgacaaaca 41 H. sapiens 309 44609 11 2431 ttctgatagttgctttagaa 42 H. sapiens 310 53590 11 111 ggaggaggtagctctaaggc 43 H. sapiens 311 53589 11 201 ccttgtatcactggcagcag 44 H. sapiens 312 53587 11 451 tgtgtaactggagaaggggt 46 H. sapiens 313 53585 11 761 ggtctaaggatataggatac 48 H. sapiens 314 53584 11 821 ctgaagtcacagtagctcca 49 H. sapiens 315 53583 11 861 ggagtccgcctcagggatcg 50 H. sapiens 316 53582 11 901 aagcccagggtgaggaagag 51 H. sapiens 317 53581 11 921 tctgaagaagggatacactg 52 H. sapiens 318 53580 11 951 agcaagcatcatcttggggc 53 H. sapiens 319 53579 11 1031 gaaatgtgaacatgtgggac 54 H. sapiens 320 53578 11 1111 gtcctgaactggcgggcact 55 H. sapiens 321 53577 11 1141 gtgcaaggcgaagtgttcac 56 H. sapiens 322 53576 11 1341 cctcagcgcctgagaatgga 57 H. sapiens 323 53574 11 1551 gagctgagaaggaagcgctg 59 H. sapiens 324 53573 11 1611 ggagcattgcccacattcac 60 H. sapiens 325 53572 11 1651 tcaggacactggccaggtgt 61 H. sapiens 326 53571 11 1771 ctcaaagcacactggaaagg 62 H. sapiens 327 53570 11 1831 cagagcaaaatgaagcacta 63 H. sapiens 328 53569 11 1971 ggctgtgaattctttcttca 64 H. sapiens 329 53568 11 2041 ggtgtcctgtcagaggagcc 65 H. sapiens 330 53567 11 2101 gatagttacgtgttcctagc 66 H. sapiens 331 53565 11 2211 gaacctgggaccaccagtag 68 H. sapiens 332 53564 11 2271 agccaaactggaagtggagg 69 H. sapiens 333 53563 11 2341 tcagccttgtctggaaccag 70 H. sapiens 334 53562 11 2402 cctgtttacttgagtgagtc 71 H. sapiens 335 246578 11 122 ctctaaggcaagagatctgg 85 H. sapiens 336 246588 11 258 tgaccagcctctctcatgct 95 H. sapiens 337 246605 11 469 gtcagtctgtttctcaatct 112 H. sapiens 338 246614 11 562 ctcacagacatgtcgaggaa 121 H. sapiens 339 246615 11 567 agacatgtcgaggaaggctt 122 H. sapiens 340 246622 11 655 gccttcactgtgtgcctcca 129 H. sapiens 341 246628 11 716 tctcgtatgccaccaagaga 135 H. sapiens 342 246629 11 726 caccaagagacaagacaatg 136 H. sapiens 343 246630 11 736 caagacaatgagattctcat 137 H. sapiens 344 246638 11 816 ggttcctgaagtcacagtag 145 H. sapiens 345 246640 11 836 ctccagtacacatttgtaca 147 H. sapiens 346 246642 11 856 agctgggagtccgcctcagg 149 H. sapiens 347 246643 11 860 gggagtccgcctcagggatc 150 H. sapiens 348 246647 11 900 gaagcccagggtgaggaaga 154 H. sapiens 349 246650 11 944 gggcagaagcaagcatcatc 157 H. sapiens 350 246652 11 967 gggcaggagcaggattcctt 159 H. sapiens 351 246654 11 987 cggtgggaactttgaaggaa 161 H. sapiens 352 246655 11 1000 gaaggaagccagtccctggt 162 H. sapiens 353 246657 11 1020 gggagacattggaaatgtga 164 H. sapiens 354 246659 11 1040 acatgtgggactttgtgctg 166 H. sapiens 355 246660 11 1050 ctttgtgctgtcaccagatg 167 H. sapiens 356 246663 11 1097 ccttcagtcctaatgtcctg 170 H. sapiens 357 246664 11 1107 taatgtcctgaactggcggg 171 H. sapiens 358 246666 11 1127 cactgaagtatgaagtgcaa 173 H. sapiens 359 246667 11 1137 tgaagtgcaaggcgaagtgt 174 H. sapiens 360 246668 11 1147 ggcgaagtgttcaccaaacc 175 H. sapiens 361 246670 11 1235 ccacgtctctgtctctggta 177 H. sapiens 362 246671 11 1245 gtctctggtacctcccgctt 178 H. sapiens 363 246672 11 1283 ccacgtctctgtctctgggc 179 H. sapiens 364 246673 11 1293 gtctctgggcctttgttccc 180 H. sapiens 365 246676 11 1348 gcctgagaatggaggtaaag 183 H. sapiens 366 246678 11 1368 tgtctggtctgggagctcgt 185 H. sapiens 367 246679 11 1378 gggagctcgttaactatgct 186 H. sapiens 368 246683 11 1451 tcaagttggacagatcttgg 190 H. sapiens 369 246685 11 1481 ttacctcacatagatgagaa 192 H. sapiens 370 246686 11 1491 tagatgagaaaactaacacc 193 H. sapiens 371 246687 11 1501 aactaacacccagaaaggag 194 H. sapiens 372 246689 11 1536 aaactcataaggcaagagct 196 H. sapiens 373 246690 11 1546 ggcaagagctgagaaggaag 197 H. sapiens 374 246691 11 1556 gagaaggaagcgctgatctt 198 H. sapiens 375 246692 11 1566 cgctgatcttctatttaatt 199 H. sapiens 376 246694 11 1641 agtctcagaatcaggacact 201 H. sapiens 377 246695 11 1661 ggccaggtgtctggtttggg 202 H. sapiens 378 246696 11 1681 tccagagtgctcatcatcat 203 H. sapiens 379 246697 11 1691 tcatcatcatgtcatagaac 204 H. sapiens 380 246698 11 1719 ccaggtctcctgaaatggga 205 H. sapiens 381 246700 11 1739 agcccagcaataccacgcag 207 H. sapiens 382 246701 11 1749 taccacgcagtccctccact 208 H. sapiens 383 246702 11 1761 cctccactttctcaaagcac 209 H. sapiens 384 246703 11 1781 actggaaaggccattagaat 210 H. sapiens 385 246704 11 1805 ccagcagagcagatctgctt 211 H. sapiens 386 246705 11 1840 atgaagcactaggtataaat 212 H. sapiens 387 246707 11 1860 atgttgttactgccaagaac 214 H. sapiens 388 246708 11 1870 tgccaagaacttaaatgact 215 H. sapiens 389 246710 11 1952 ttccacacgaaccttgtggg 217 H. sapiens 390 246713 11 2003 caatatacccaggccacaag 220 H. sapiens 391 246714 11 2013 aggccacaagagtggacgtg 221 H. sapiens 392 246715 11 2023 agtggacgtgaaccacaggg 222 H. sapiens 393 246717 11 2043 tgtcctgtcagaggagccca 224 H. sapiens 394 246721 11 2105 gttacgtgttcctagcagga 228 H. sapiens 395 246722 11 2115 cctagcaggaccaactacag 229 H. sapiens 396 246727 11 2166 agtgagacatcttcttgctg 234 H. sapiens 397 246729 11 2186 ctggatttccaagctgagag 236 H. sapiens 398 246730 11 2196 aagctgagaggacgtgaacc 237 H. sapiens 399 246731 11 2205 ggacgtgaacctgggaccac 238 H. sapiens 400 246733 11 2225 cagtagccatcttgtttgcc 240 H. sapiens 401 246734 11 2235 cttgtttgccacatggagag 241 H. sapiens 402 246735 11 2245 acatggagagagactgtgag 242 H. sapiens 403 246736 11 2255 agactgtgaggacagaagcc 243 H. sapiens 404 246737 11 2265 gacagaagccaaactggaag 244 H. sapiens 405 246738 11 2275 aaactggaagtggaggagcc 245 H. sapiens 406 246739 11 2285 tggaggagccaagggattga 246 H. sapiens 407 246740 11 2295 aagggattgacaaacaacag 247 H. sapiens 408 246742 11 2315 agccttgaccacgtggagtc 249 H. sapiens 409 246743 11 2325 acgtggagtctctgaatcag 250 H. sapiens 410 246745 11 2345 ccttgtctggaaccagatct 252 H. sapiens 411 246746 11 2355 aaccagatctacacctggac 253 H. sapiens 412 246748 11 2378 ccaggtctataagccaataa 255 H. sapiens 413 115255 252 1 atggagaagctactatggtg 260 R. norvegicus 414 115256 252 21 tcttctgatcacgataagct 261 R. norvegicus 415 115257 252 41 tctctcaggcttttggtcat 262 R. norvegicus 416 115258 252 61 gaagacatgtctaaacaggc 263 R. norvegicus 417 115259 252 81 cttcgtatttcccggagtgt 264 R. norvegicus 418 115260 252 101 cagctactgcctatgtgtcc 265 R. norvegicus 419 115261 252 121 ctggaagcagagtcaaagaa 266 R. norvegicus 420 115262 252 141 gccactggaagccttcactg 267 R. norvegicus 421 115263 252 161 tgtgtctctatgcccacgct 268 R. norvegicus 422 115265 252 201 catcttctcttacgctacca 270 R. norvegicus 423 115266 252 221 agacgagctttaacgagatt 271 R. norvegicus 424 115267 252 261 tcaagggtttagtattgcag 272 R. norvegicus 425 115268 252 281 taggtgggcctgaaatactg 273 R. norvegicus 426 115269 252 301 ttcagtgcttcagaaattcc 274 R. norvegicus 427 115271 252 411 tctgcagaagggctacattg 276 R. norvegicus 428 115272 252 431 tggggacaaatgcaagcatc 277 R. norvegicus 429 115274 252 471 ctcgtatggcggtggctttg 279 R. norvegicus 430 115276 252 511 ggagacattggagatgtgaa 281 R. norvegicus 431 115277 252 531 catgtgggactttgtgctat 282 R. norvegicus 432 115278 252 551 ctccagaacagatcaatgca 283 R. norvegicus 433 115279 252 571 gtctatgttggtagggtatt 284 R. norvegicus 434 115280 252 601 gttttgaactggcgggcact 285 R. norvegicus 435 115281 252 621 gaagtatgaaacacacggtg 286 R. norvegicus 436 115283 252 661 ctgtggcccttgactgactg 288 R. norvegicus 437 115284 252 671 Tgactgactgttgtgagtcc 289 R. norvegicus 438

As these “preferred target segments” have been found by experimentation to be open to, and accessible for, hybridization with the antisense compounds of the present invention, one of skill in the art armed with the knowledge of the present invention will recognize or be able to ascertain, using no more than routine experimentation, further embodiments of the invention that encompass other compounds that specifically hybridize to these preferred target segments and consequently inhibit the expression of C-reactive protein.

According to the present invention, antisense compounds include antisense oligomeric compounds, antisense oligonucleotides, siRNAs, external guide sequence (EGS) oligonucleotides, alternate splicers, and other short oligomeric compounds that hybridize to at least a portion of the target nucleic acid.

Example 17 Western Blot Analysis of C-Reactive Protein Protein Levels

Western blot analysis (immunoblot analysis) is carried out using standard methods. Cells are harvested 16-20 hours after oligonucleotide treatment, washed once with PBS, suspended in Laemmli buffer (100 μl/well), boiled for 5 minutes and loaded on a 16% SDS-PAGE gel. Gels are run for 1.5 hours at 150 V, and transferred to membrane for western blotting. Appropriate primary antibody directed to C-reactive protein is used, with a radiolabeled or fluorescently labeled secondary antibody directed against the primary antibody species. Bands are visualized using a PHOSPHORIMAGER™ instrument (Molecular Dynamics, Sunnyvale Calif.).

Example 18 Antisense Inhibition of Rabbit C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.

In accordance with the present invention, a series of antisense compounds was designed to target different regions of the rabbit C-reactive protein RNA, using published sequences (GENBANK® accession number M13497.1, incorporated herein as SEQ ID NO: 439). The compounds are shown in Table 5. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 5 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

The compounds were analyzed for their effect on rabbit C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Probes and primers to rabbit C-reactive protein were designed to hybridize to a rabbit C-reactive protein sequence, using published sequence information (GENBANK® accession number M13497.1, incorporated herein as SEQ ID NO: 439). For rabbit C-reactive protein the PCR primers were: forward primer: GGCGCGAGCTGACATATCA (SEQ ID NO: 440) reverse primer: CTTGGCAGAGCTCAGGGC (SEQ ID NO: 441) and the PCR probe was: FAM-TACGTGGTGAAGTACATGTCAAGCCCCAG-TAMRA (SEQ ID NO: 442) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For rabbit GAPDH the PCR primers were: forward primer: TGTTCTAGAGACAGCCGCATCTT(SEQ ID NO: 443) reverse primer: CACCGACCTTCACCATCTTGT(SEQ ID NO: 444) and the PCR probe was: 5′ JOE-TTGTGCAGTGCCAGCCTCGTCTCA-TAMRA 3′ (SEQ ID NO: 445) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye. Data, shown in Table 5, are averages from three experiments in which primary rabbit hepatocytes were treated with 10 nM of the antisense oligonucleotides of the present invention. If present, “N.D.” indicates “no data”.

TABLE 5 Inhibition of rabbit C-reactive protein mRNA levels by chimeric phosphorothioate oligonucleotides having 2′-MOE wings and a deoxy gap Target ISIS Seq ID Start % SEQ # Region NO Site SEQUENCE Inhib ID NO 196123 5′UTR 439 3 cgtctctggctgaaggctca N.D. 446 196124 5′UTR 439 31 ggctcagaatccactccttt N.D. 447 196125 5′UTR 439 51 gccaccagtgctaccgagca N.D. 448 196126 Start Codon 439 71 cttctccatggtcactccct N.D. 449 196127 Coding 439 131 catgcctgcctggtcagaca N.D. 450 196128 Coding 439 181 gacacgtaggaattatctga N.D. 451 196129 Coding 439 201 tctttaactgtgcgttgagg N.D. 452 196130 Coding 439 241 gtgtagaagtagaggcacac N.D. 453 196131 Coding 439 261 cacgagtcatggacagatca N.D. 454 196132 Coding 439 341 actatatcctatgtccttgg N.D. 455 196133 Coding 439 371 gaatattatttcatctccac N.D. 456 196134 Coding 439 421 tcccagcttgcacagaggtg N.D. 457 196135 Coding 439 441 ctgcaatgcctgtgctggac N.D. 458 196136 Coding 439 461 cttcccatctacccagagct N.D. 459 196137 Coding 439 491 gcccttcttcagactcttcc N.D. 460 196138 Coding 439 526 cccagaataatgcttgcctc N.D. 461 196139 Coding 439 601 atgttcacatttccaatgtc N.D. 462 196140 Coding 439 621 gtgaaagtgcatagtcccac N.D. 463 196141 Coding 439 661 ctaaaggtcccaccagcata N.D. 464 196142 3′UTR 439 771 caagaagcaccttcaggatc N.D. 465 196143 3′UTR 439 811 ggtccacagccagaagtatg N.D. 466 196144 3′UTR 439 841 tagcaggcattcagtatatg N.D. 467 196145 3′UTR 439 921 caatgtagtccacaagatcc N.D. 468 196146 3′UTR 439 1111 accaatgtcctcttcccagt N.D. 469 196147 3′UTR 439 1181 gtgaatgtgggcaactacct N.D. 470 196148 3′UTR 439 1201 ttctgagagtgaatagccct N.D. 471 196149 3′UTR 439 1221 agtcctagctgatagcctaa N.D. 472 196150 3′UTR 439 1251 agaatgagcactgtgaactc N.D. 473 196151 3′UTR 439 1371 gcaagccttctctctaaggc N.D. 474 196152 3′UTR 439 1411 tgactatacccagatgccac N.D. 475 196153 3′UTR 439 1561 cctgactcttgtggcctgaa N.D. 476 196154 3′UTR 439 1581 taggacagcctgagtctcac N.D. 477 196155 3′UTR 439 1601 gagagatggactactctggt N.D. 478 196156 3′UTR 439 1621 gcaacatacagccatccatg N.D. 479 196157 3′UTR 439 1641 gtctgtaattgctcctgcta N.D. 480 196158 3′UTR 439 1681 acgtcttatccccagagtcc N.D. 481 196159 3′UTR 439 1751 tggtcaacaagatagctgca N.D. 482 196160 3′UTR 439 1801 agctctcagctcttccagct N.D. 483 196161 3′UTR 439 1821 cagattccaccactctgtca N.D. 484 196162 3′UTR 439 1881 caggaagtccaggtatagat N.D. 485 196163 3′UTR 439 1901 agctatattagtcacagacc N.D. 486 196164 3′UTR 439 1951 cctctaatgcaaccatcaga N.D. 487 196165 3′UTR 439 2011 atggtcagtctgagctcaca N.D. 488 196166 3′UTR 439 2041 tgccacggactctcccttgc N.D. 489 196167 3′UTR 439 2071 ccttgcaggagactccagat N.D. 490 196168 3′UTR 439 2221 tgaccatgacagcagatttg N.D. 491 196263 3′UTR 439 2 gtctctggctgaaggctcag N.D. 492 196264 Coding 439 525 ccagaataatgcttgcctct N.D. 493 280264 5′UTR 439 27 cagaatccactcctttggag 66 494 280265 5′UTR 439 61 gtcactccctgccaccagtg 74 495 280266 Start Codon 439 81 accacagcagcttctccatg 25 496 280267 Coding 439 111 tattagagaagctgaccaag 27 497 280268 Coding 439 141 ccttcttgtgcatgcctgcc 74 498 280269 Coding 439 221 agtgaaggctttgagtggct 25 499 280270 Coding 439 311 gaggatctcgttaaattgtc 50 500 280271 Coding 439 364 atttcatctccacccactga 60 501 280272 Coding 439 411 cacagaggtgagttggatcc 59 502 280273 Coding 439 431 tgtgctggactcccagcttg 63 503 280274 Coding 439 451 acccagagctctgcaatgcc 45 504 280275 Coding 439 495 tgtagcccttcttcagactc 46 505 280276 Coding 439 544 aacgaatcctgatcctgccc 70 506 280277 Coding 439 641 gacggtattaatctcttctg 70 507 280278 3′UTR 439 773 cccaagaagcaccttcagga 92 508 280279 3′UTR 439 851 gctgtttatgtagcaggcat 91 509 280280 3′UTR 439 881 ctctggtgttgaagaaggca 86 510 280281 3′UTR 439 1041 ctaggcgtcaactttctcat 100 511 280282 3′UTR 439 1071 tgacttaaaagtcacttctc 46 512 280283 3′UTR 439 1091 taagtggtgaacctgtcttg 72 513 280284 3′UTR 439 1121 tagacagaagaccaatgtcc 79 514 280285 3′UTR 439 1171 gcaactaccttctactctct 60 515 280286 3′UTR 439 1211 gatagcctaattctgagagt 64 516 280287 3′UTR 439 1291 atcttctatttcagaagact 81 517 280288 3′UTR 439 1312 agaatggcacagtattgctg 72 518 280289 3′UTR 439 1401 cagatgccacttttgcccag 65 519 280290 3′UTR 439 1447 atataagcaagcaaacaccc 86 520 280291 3′UTR 439 1571 tgagtctcaccctgactctt 56 521 280292 3′UTR 439 1611 gccatccatggagagatgga 47 522 280293 3′UTR 439 1631 gctcctgctagcaacataca 85 523 280294 3′UTR 439 1671 cccagagtccacactgaatc 67 524 280295 3′UTR 439 1725 cccaggttcatgccttctaa 92 525 280296 3′UTR 439 1771 cttctccatctccctccaca 58 526 280297 3′UTR 439 1861 ttggttccatgcaaggctga 39 527 280298 3′UTR 439 1891 gtcacagacccaggaagtcc 81 528 280299 3′UTR 439 1919 ttcacccaggtaaccaagag 77 529 280300 3′UTR 439 1961 gatagtcagacctctaatgc 73 530 280301 3′UTR 439 2031 tctcccttgcaaggacagca 57 531 280302 3′UTR 439 2051 gagattagagtgccacggac 68 532 280303 3′UTR 439 2081 cagcaagaatccttgcagga 85 533 280304 3′UTR 439 2124 cccacacgaatgactaattg 75 534 280305 3′UTR 439 2155 gaataagagcattaagaccc 62 535 280306 3′UTR 439 2211 agcagatttgagcttctcaa 22 536 280307 3′UTR 439 2271 gaggagtctgtttctacaac 10 537 280308 3′UTR 439 2281 ccttacctttgaggagtctg 11 538 280309 3′UTR 439 2285 aagcccttacctttgaggag 8 539

As shown in Table 5, SEQ ID NOs 494, 495, 498, 501, 502, 503, 506, 507, 508, 509, 510, 511, 513, 514, 515, 516, 517, 518, 519, 520, 521, 523, 524, 525, 526, 528, 529, 530, 531, 532, 533, 534 and 535 demonstrated at least 25% inhibition of rabbit C-reactive protein expression in this experiment and are therefore preferred.

Example 19

Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment of the present invention, five oligonucleotides were selected for additional dose-response studies. Cytokine-induced Hep3B cells were treated with 50, 100 and 150 nM of ISIS 133712, 133719, 133726, 140180 and 140177 and mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.

Results of these studies are shown in Table 6. Data are averages from two experiments and are expressed as percent inhibition of cytokine-induced control.

TABLE 6 Inhibition of cytokine-induced human C-reactive protein mRNA expression in Hep3B cells 24 hours after oligonucleotide treatment % Inhibition Dose of oligonucleotide ISIS # 50 nM 100 nM 150 nM SEQ ID NO 133712 60 84 77 22 133719 0 46 76 29 133726 75 85 92 36 140177 31 45 15 53 140180 26 59 91 56

As shown in Table 6, ISIS 133712, ISIS 133726 and ISIS 140180 were effective at reducing human C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.

Example 20 Antisense Inhibition of rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment of the present invention, three oligonucleotides were selected for additional dose-response studies. Rat primary hepatocytes were treated with 50, 150 and 300 nM of ISIS 197181, 197178, 197183 and 197190. Target mRNA levels were measured at 24 hours post oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.

Results of these studies are shown in Table 7. Data are averages from three experiments and are expressed as percent inhibition of control.

TABLE 7 Inhibition of rat C-reactive protein mRNA expression in primary hepatocytes: dose response % Inhibition Dose, nM ISIS # SEQ ID NO 50 150 300 197181 278 38 37 37 197178 275 38 56 65 197183 280 9 73 84 197190 287 55 71 85

As shown in Table 7, ISIS 197181, ISIS 197178, ISIS 197183 and ISIS 197190 were effective at reducing rat C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.

Example 21 Antisense Inhibition of Rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: In Vivo Dose Response Studies

In a further embodiment of the present invention, three oligonucleotides were selected for additional in vivo dose response studies. Three-month old male Sprague-Dawley rats received subcutaneous injections of saline or 1, 10 or 25 mg/kg of ISIS 197178 (SEQ ID NO: 275), ISIS 197183 (SEQ ID NO: 280) and ISIS 197190 (SEQ ID NO: 287) twice weekly for 2 weeks. At the end of the treatment period, animals were sacrificed and liver target mRNA levels were measured by real-time PCR as described in other examples herein. Saline treated animals served as a control. Rat liver C-reactive protein mRNA levels were reduced by 5% following a 1 mg/kg dose of 197178 and by 18% following a 10 mg/kg dose of ISIS 197190.

Example 22 Antisense Inhibition of Rabbit C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment of the present invention, four oligonucleotides were selected for additional dose-response studies. Rabbit primary hepatocytes were treated with 10, 50 150 and 300 nM of ISIS 280279, 280290, 280298 and 282303. mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.

Results of these studies are shown in Table 8. Data are averages from two experiments and are expressed as percent inhibition of control.

TABLE 8 Inhibition of rabbit C-reactive protein mRNA expression in rabbit primary hepatocytes: dose response % Inhibition Dose of oligonucleotide ISIS # SEQ ID NO 10 nM 50 nM 150 nM 300 nM 280279 509 55 53 62 35 280290 520 49 77 84 81 280298 528 55 53 62 36 282303 533 40 76 80 87

As shown in Table 8, ISIS 280303 and ISIS 280290 were effective at reducing C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.

Example 23 Antisense Inhibition of C-Reactive Protein Expression (ISIS 133726) in Liver Tissue of the Cynomolgus Monkey

In a further embodiment, male Cynomolgus monkeys were treated with ISIS 133726 (SEQ ID NO: 36) and levels of C-reactive protein mRNA were measured in liver tissue.

Male Cynomolgus monkeys were divided into two treatment groups, control animals (n=4; saline treatment only) and treated animals (n=8; treated with ISIS 133726). Animals in the treatment group were dosed subcutaneously twice a week for 4 weeks with 10 mg/kg and 20 mg/kg of ISIS 133726, respectively. Animals in the control group were treated with saline only. Three days later, all animals were sacrificed and livers were taken for analysis of C-reactive protein mRNA. Levels of mRNA were normalized to those of the saline treated animals. In animals treated with 10 mg/kg and 20 mg/kg ISIS 133726, C-reactive protein mRNA levels within liver were reduced by 42% and 69%, respectively.

Levels of the liver enzymes ALT and AST were measured weekly and showed no change, indicating no ongoing toxic effects of the oligonucleotide treatment.

The results of this study demonstrate a significant reduction in liver C-reactive protein mRNA upon treatment with ISIS 133726.

Example 24 Modulation of Mouse C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.

In accordance with the present invention, a series of antisense compounds was designed to target different regions of the mouse C-reactive protein RNA, using published sequences (GENBANK® accession number NM_(—)007768.1, incorporated herein as SEQ ID NO: 540). The compounds are shown in Table 9. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 9 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

The compounds were analyzed for their effect on mouse C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Probes and primers to mouse C-reactive protein were designed to hybridize to a mouse C-reactive protein sequence, using published sequence information (GENBANK® accession number NM_(—)007768.1, incorporated herein as SEQ ID NO: 540). For mouse C-reactive protein the PCR primers were: forward primer: TGGATTGATGGGAAACCCAA (SEQ ID NO: 541) reverse primer: GCATCTGGCCCCACAGTG (SEQ ID NO: 542) and the PCR probe was: FAM-TGCGGAAAAGTCTGCACAAGGGC-TAMRA (SEQ ID NO: 543) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For mouse GAPDH the PCR primers were: forward primer: GGCAAATTCAACGGCACAGT (SEQ ID NO: 544) reverse primer: GGGTCTCGCTCCTGGAAGAT (SEQ ID NO: 545) and the PCR probe was: 5′ JOE-AAGGCCGAGAATGGGAAGCTTGTCATC-TAMRA 3′ (SEQ ID NO: 546) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye. Data, shown in Table 9, are from an experiment in which primary mouse hepatocytes were treated with 150 nM the antisense oligonucleotides of the present invention. The data are presented as percent expreeion relative to control, untreated cells. If present, “N.D.” indicates “no data”.

TABLE 9 Modulation of mouse C-reactive protein mRNA levels by chimeric phosphorothioate oligonucleotides having 2′-MOE wings and a deoxy gap TARGET ISIS SEQ ID TARGET % SEQ # REGION NO SITE SEQUENCE CONTROL ID NO 133685 5′UTR 540 21 TTTGTCTGAAAGATCAAGGA 83 547 133686 5′UTR 540 31 AGGACAGTGTTTTGTCTGAA 55 548 133687 start codon 540 71 CTTCTCCATGGCTATGGATG 68 549 133688 start codon 540 81 ACCAGAGTAGCTTCTCCATG 131 550 133689 coding 540 221 AGTAAAGGTGTTCAGTGGCT 84 551 133690 coding 540 301 TTAGAGTTCTTCTTGGTAGC 36 552 133691 coding 540 371 GAATCGTACTTCAGCACCAC 139 553 133692 coding 540 411 CACAGATGTGTGTTGGAGCC 128 554 133693 coding 540 441 CTACAATCCCCGTAGCAGAC 122 555 133694 coding 540 531 CCTGCCCCAAGATGATGCTT 238 556 133695 coding 540 661 CTGAGTGTCCCACCAACATA 183 557 133696 coding 540 711 CATCACCCTGTGCTTTATAG 175 558 133697 stop codon 540 741 GTCAGGACCACAGCTGCGGC 48 559 133698 stop codon 540 761 TTCAGGGTTCACAACAGTAG 67 560 133699 3′UTR 540 781 AATGTAATCCCAGGAGGTGC 44 561 133700 3′UTR 540 891 GTGCTCTAGTGCTGAGGACC 102 562 133701 3′UTR 540 1091 CTCCTTTCTGTGCATCTATT 70 563 133702 3′UTR 540 1261 AGATGATAGGTATTATGCAT 120 564 133703 3′UTR 540 1361 CCAGTGTCCAGTCTTCAACA 52 565 133704 3′UTR 540 1381 GGGCCCTCCTGATAGATTAT 87 566 133705 3′UTR 540 1425 GTAATCAGTGGCTGCTGAGA 46 567 133706 3′UTR 540 1451 ACAGAACCCTATATGAAGAG 94 568 133707 3′UTR 540 1508 AGACCTGCATAATGACACCA 34 569 133708 3′UTR 540 1551 GCACAGTGTAGTCAGTGCTC 50 570 147859 5′UTR 540 1 CAAGGAGTCCTGGAACGCCT 414 571 147860 5′UTR 540 41 CTGGACTAAGAGGACAGTGT 81 572 147861 coding 540 102 AGCTGATCATGATCAGAAGG 435 573 147862 coding 540 191 TGCTTCCAGAGACACATAGG 262 574 147863 coding 540 241 GTGTAGAAATGGAGACACAC 212 575 147864 coding 540 281 ATAAGAGAAGACACTGAAGC 129 576 147865 coding 540 501 CCACAGTGTAGCCCTTGTGC N.D. 577 147866 coding 540 521 GATGATGCTTGCATCTGGCC 148 578 147867 coding 540 544 TACGAGTCCTGCTCCTGCCC 106 579 147868 coding 540 571 GACTGCTTTGCATCAAAGTC 26 580 147869 coding 540 701 TGCTTTATAGTTCAGTGCCC 72 581 147870 3′UTR 540 801 TAACCCGAGACAAGGGAGAG 95 582 147871 3′UTR 540 841 CAGAACAGACCTACAACATC 89 583 147872 3′UTR 540 861 GAAGTGAAAGGCCATATTCA 91 584 147873 3′UTR 540 931 TAGTGGGATGCTTATGCTGG 275 585 147874 3′UTR 540 1141 AATACAGCACTCAAGATGAC 212 586 147875 3′UTR 540 1181 ATAGGAAAGGATCTGAAGAG 93 587 147876 3′UTR 540 1211 CATCATGAATTTGAGAGAGA 138 588 147877 3′UTR 540 1281 AGGTAGATAGATTGATTGAT 314 589 147878 3′UTR 540 1301 CTGATGAATAGATGATAGAT 228 590 147879 3′UTR 540 1321 GTAATCAGTAAGATGGATGA 381 591 147880 3′UTR 540 1378 CCCTCCTGATAGATTATCCA 38 592 147881 3′UTR 540 1501 CATAATGACACCAATTGACA 101 593 147882 3′UTR 540 1521 GGTTGCCCAAACAAGACCTG 144 594 147883 3′UTR 540 1541 GTCAGTGCTCCATCACTCTA 44 595 147884 3′UTR 540 1561 CTGATTCTGAGCACAGTGTA 233 596

Example 25 Antisense Inhibition of Mouse C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment of the present invention, seven oligonucleotides were selected for additional dose-response studies. Primary mouse hepatocytes were treated with 10, 50 150 and 300 nM of ISIS 133688, 133697, 133702, 133708, 147880, 147868, 147883. mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.

Results of these studies are shown in Table 10. Data are averages from three experiments and are expressed as percent inhibition of control.

TABLE 10 Inhibition of mouse C-reactive protein mRNA expression in mouse primary hepatocytes: dose response % Inhibition Dose of oligonucleotide ISIS # SEQ ID NO 10 nM 50 nM 150 nM 300 nM 133688 550 59 75 75 67 133697 559 63 63 76 76 133702 564 43 35 45 52 133708 570 72 74 72 72 147868 580 59 59 76 80 147880 592 61 69 82 77 147883 595 90 82 91 70

As demonstrated in Table 10, ISIS 113697 and 147868 inhibited C-reactive protein expression in a dose-dependent manner.

Example 26 Antisense Inhibition of Rabbit C-Reactive Protein In Vivo

In a further embodiment of the present invention, ISIS 280303 (SEQ ID NO: 533) was tested for its effects on C-reactive proteins in rabbits. Male New Zealand white rabbits were fed a normal diet and received subcutaneous injections of 20 mg/kg ISIS 280303 twice per week for a period of three weeks. Saline-injected animals served as a control. Oligonucleotide- and saline-injected groups included 4 animals each. At the end of the treatment period, the animals were sacrificed and the liver was isolated for RNA extraction. C-reactive protein mRNA levels in liver were measured by real-time PCR as described by other examples herein. Relative to the saline control, ISIS 280303 inhibited C-reactive protein mRNA expression by 52%.

Example 27 Rabbit Models for Study of Atherosclerotic Plaque Formation

The Watanabe heritable hyperlipidemic (WHHL) strain of rabbit is used as a model for atherosclerotic plaque formation. New Zealand white rabbits on a high-fat diet are also used as a model of atherosclerotic plaque formation. Treatment of WHHL or high fat fed New Zealand white rabbits with C-reactive protein antisense compounds is used to test their potential as therapeutic or prophylactic treatments for atherosclerotic plaque disease. Rabbits are injected with 5, 10, 29 or 50 mg/kg of antisense oligonucleotides targeted to C-reactive protein. Animals treated with saline alone or a control oligonucleotide serve as controls. Throughout the treatment, serum samples are collected and evaluated for serum lipids, including cholesterol, LDL-cholesterol, VLDL-cholesterol, HDL-cholesterol and triglycerides, by routine clinical analysis. Liver tissue triglyceride content is measured using a Triglyceride GPO Assay (Sigma-Aldrich, St. Louis, Mo.). Liver, kidney, heart, aorta and other tissues are procured and processed for histological analysis using routine procedures. Liver and kidney tissues are examined for evidence of basophilic granules and inflammatory infiltrates. The aorta is stained using routine procedures, with a dye such as Sudan IV, to visualize atherosclerosis. Aorta tissue is also embedded in paraffin and sectioned, using routine histological procedures, and the sections are evaluated for the presence of intimal lesions.

Example 28 A Mouse Model for Atherosclerotic Plaque Formation: Human C-Reactive Protein Transgenic Mice Lacking the LDL Receptor Gene

The LDL receptor is responsible for clearing C-reactive protein-containing LDL particles. Without the LDL receptor, animals cannot effectively clear C-reactive protein-containing LDL particles from the plasma, thus the serum levels of C-reactive protein and LDL cholesterol are markedly elevated. Mice expressing the human C-reactive protein transgene (TgN-hApoB +/+) and mice deficient for the LDL receptor (LDLr −/−) are both used as animal models of atherosclerotic plaque development. When the LDL receptor deficiency genotype is combined with a human C-reactive protein transgenic genotype (TgN-hApoB +/+; LDLr −/−), atherosclerotic plaques develop rapidly. In accordance with the present invention, mice of this genetic background are used to investigate the ability of compounds to prevent atherosclerosis and plaque formation.

Male TgN-hApoB +/+; LDLr −/− mice are treated twice weekly with 10 or 20 mg/kg of C-reactive protein antisense oligonucleotides for 12 weeks. Control groups are treated with saline or control oligonucleotide. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides are measured at 2, 4, 6, 8 and 12 weeks by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). Mouse apolipoprotein mRNA in liver is measured at 12 weeks.

Additionally, a four month study is performed in TgN-hApoB +/+; LDLr −/− mice, with treatment conditions used in the 12 week study. Mice are treated for 4 months with antisense oligonucleotides targeted to C-reactive protein to evaluate the ability of such compounds to prevent atherosclerotic plaque formation. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides are measured at 2, 4, 6, 8, 12 and 16 weeks by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). Mouse C-reactive protein mRNA in liver at 16 weeks is measured by real-time PCR. At the end of the 4-month treatment period, additional treated mice are anesthetized and perfused with 10% formalin. The perfused arterial tree is isolated and examined for the presence of atherosclerotic plaques. Sections of the arterial tree are embedded in paraffin and prepared for histological analysis using routine methods.

Example 29 A Mouse Model for Atherosclerotic Plaque Formation: B6.129P-Apoe^(tmlUnc) Knockout Mice

B6.129P-ApoE^(tmlUnc) knockout mice (herein referred to as ApoE knockout mice) obtained from The Jackson Laboratory (Bar Harbor, Me.), are homozygous for the Apoe^(tmlUnc) mutation and show a marked increase in total plasma cholesterol levels that are unaffected by age or sex. These animals present with fatty streaks in the proximal aorta at 3 months of age. These lesions increase with age and progress to lesions with less lipid but more elongated cells, typical of a more advanced stage of pre-atherosclerotic lesion.

The mutation in these mice resides in the apolipoprotein E (ApoE) gene. The primary role of the ApoE protein is to transport cholesterol and triglycerides throughout the body. It stabilizes lipoprotein structure, binds to the low density lipoprotein receptor (LDLR) and related proteins, and is present in a subclass of HDLs, providing them the ability to bind to LDLR. ApoE is expressed most abundantly in the liver and brain. Female B6.129P-ApoetmlUnc knockout mice (ApoE knockout mice) were used in the following studies to evaluate C-reactive protein antisense oligonucleotides as potential compounds for preventing atherosclerotic plaque formation.

Female ApoE knockout mice range in age from 5 to 7 weeks and are placed on a normal diet for 2 weeks before study initiation. ApoE knockout mice are then fed ad libitum a 60% fat diet, with 0.15% added cholesterol to induce dyslipidemia and obesity. Control animals are maintained on a high-fat diet with no added cholesterol. After overnight fasting, mice from each group are dosed intraperitoneally every three days with 5, 25 or 50 mg/kg of antisense oligonucleotide targeted to C-reactive protein, for a period of six weeks. Control groups consist of animals injected with a control oligonucleotide and animals injected with saline.

During and at the end of the treatment period, glucose levels, cholesterol (total cholesterol, HDL-cholesterol and LDL-cholesterol), triglyceride and liver enzyme levels are measured by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). At study termination and forty-eight hours after the final injections, animals were sacrificed and evaluated for target mRNA levels in liver by real-time PCR. At the end of the treatment period, additional treated mice are anesthetized and perfused with 10% formalin. The perfused arterial tree is isolated and examined for the presence of atherosclerotic plaques. Sections of the arterial tree are embedded in paraffin and prepared for histological analysis using routine methods.

Example 30 Antisense Inhibition of Human C-Reactive Protein mRNA Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Study

In a further embodiment, four oligonucleotides were selected for an additional dose-response study. Cytokine-induced Hep3B cells, cultured as described herein, were treated with 25, 50, 75 and 150 nM of ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205), ISIS 330031 (SEQ ID NO: 224) and ISIS 133726 (SEQ ID NO: 36). 24 hours following oligonucleotide treatment, human C-reactive protein mRNA levels were quantitated using real-time PCR as described herein. ISIS 113529 (CTCTTACTGTGCTGTGGACA; incorporated herein as SEQ ID NO: 597) does not target C-reactive protein and served as a control. Cells were treated with 150 and 300 nM of ISIS 113529. ISIS 113529 is a chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Levels of C-reactive protein mRNA expression were also measured in cytokine-induced cells that were not treated with oligonucleotide (induced) and cells that receive neither cytokine nor oligonucleotide treatment (basal).

The results of this dose-response study are shown in Table 11. Data are averages from three experiments. Results were normalized to expression of C-reactive protein mRNA from cytokine-induced cells. Basal C-reactive protein mRNA was 11% of the cytokine-induced expression. Cells treated with 150 and 300 nM of ISIS 113529 expressed C-reactive protein mRNA at 76 and 84% of the cytokine-induced levels, respectively.

TABLE 11 Inhibition of cytokine-induced human C-reactive protein mRNA expression in Hep3B cells 24 hours after oligonucleotide treatment % C-reactive protein mRNA expression relative to cytokine-induced cells Dose of oligonucleotide ISIS # 25 nM 50 nM 75 nM 150 nM 329956 45 41 21 19 330012 48 33 22 12 330031 53 29 21 26 133726 94 51 33 23

These data reveal that ISIS 329956, ISIS 330012, ISIS 330031 and ISIS 133726 inhibited human C-reactive protein expression in cytokine-induced Hep3B cells, in a dose-dependent manner.

Example 31 Antisense Inhibition of Human C-Reactive Protein Secretion by Hep3B Cells: Dose Response Study

In a further embodiment of the present invention, four oligonucleotides were selected for an additional dose-response study to measure the effect of antisense oligonucleotide treatment on the secretion of C-reactive protein from cytokine-induced Hep3B cells. Cytokine-induced Hep3B cells, cultured as described herein, were treated with 150 and 300 nM of ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205), ISIS 330031 (SEQ ID NO: 224) and ISIS 133726 (SEQ ID NO: 36). Cells were treated with the control oligonucleotide ISIS 113529 (SEQ ID NO: 597) at 150 and 300 nM. 24 hours following oligonucleotide treatment human C-reactive protein secreted from cytokine-induced Hep3B cells into the culture media was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.). C-reactive protein secretion was also measured in cytokine-induced cells that were not treated with oligonucleotide (induced) and cells that received neither cytokine nor oligonucleotide treatment (basal).

The results of this dose-respose study are shown in Table 12. Data are averages from three experiments. Results were normalized to C-reactive protein levels secreted from cytokine-induced cells. Basal C-reactive protein level in the culture media was 8% of the cytokine-induced level.

TABLE 12 Inhibition of cytokine-induced human C-reactive protein secretion from Hep3B cells 24 hours after oligonucleotide treatment % C-reactive protein secretion relative to cytokine-induced cells Dose of oligonucleotide 150 nM 300 nM 329956 71 65 330012 69 47 330031 78 107 133726 76 55 113529 127 113

These data reveal that ISIS 329956, ISIS 330012 and ISIS 133726 inhibited secretion of C-reactive protein from cytokine-induced Hep3B cells, in a dose-dependent manner. ISIS 330031 inhibited C-reactive protein secretion at the lower dose of oligonucleotide. The control oligonucleotide ISIS 113529 did not inhibit C-reactive protein secretion.

Example 32 Antisense Oligonucleotides Targeted to C-Reactive Protein Having Variable 2′-deoxy Gaps and Variable 2′-MOE Wings

In a further embodiment, antisense oligonucleotides targeted to C-reactive protein were designed using the nucleotide sequences of SEQ ID NOs 36 and 205 and employing various gap and wing segment lengths. The compounds are shown in Table 13. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 13 are chimeric oligonucleotides (“gapmers”) ranging from 16 to 20 nucleotides in length. The “gap” region consists of 2′-deoxynucleotides, which is flanked on one or both sides (5′ and 3′ directions) by “wings” composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The length of the 2′-deoxy gap varies from 10 to 18 nucleotides and the length of the 2′-MOE wings varies from 1 to 5 nucleotides. The exact structure of each oligonucleotide is designated in Table 13 as the “configuration”. A designation of 3˜14˜3, for instance, indicates that the first (5′-most) 3 nucleotides and the last (3′-most) 3 nucleotides are 2′-MOE nucleotides and the 14 nucleotides in the gap are 2′-deoxynucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

TABLE 13 Antisense oligonucleotides targeted to C-reactive protein having varying 2′-deoxy gaps and varying 2′-MOE wings TARGET ISIS SEQ ID TARGET SEQ # REGION NO SITE SEQUENCE Configuration ID NO 353490 3′UTR 4 1671 GCACTCTGGACCCAAACCAG 4~12~4 36 353491 3′UTR 4 1671 GCACTCTGGACCCAAACCAG 3~14~3 36 353492 3′UTR 4 1671 GCACTCTGGACCCAAACCAG 2~16~2 36 353470 3′UTR 4 1719 TCCCATTTCAGGAGACCTGG 4~12~4 205 353471 3′UTR 4 1719 TCCCATTTCAGGAGACCTGG 3~16~1 205 353472 3′UTR 4 1719 TCCCATTTCAGGAGACCTGG 2~16~2 205 353512 3′UTR 4 1719 TCCCATTTCAGGAGACCTGG 3~14~3 205 353480 3′UTR 4 1719 TCCCATTTCAGGAGACCTG 5~10~4 598 353486 3′UTR 4 1719 CCCATTTCAGGAGACCTGG 4~10~4 599 353499 3′UTR 4 1672 GCACTCTGGACCCAAACCA 5~10~4 600 353502 3′UTR 4 1671 CACTCTGGACCCAAACCAG 4~10~5 601 353481 3′UTR 4 1720 TCCCATTTCAGGAGACCT 5~10~3 602 353483 3′UTR 4 1721 CCCATTTCAGGAGACCTG 4~10~4 603 353487 3′UTR 4 1719 CCATTTCAGGAGACCTGG 3~10~5 604 353500 3′UTR 4 1672 GCACTCTGGACCCAAACC 5~10~3 605 353503 3′UTR 4 1671 ACTCTGGACCCAAACCAG 3~10~5 606 353505 3′UTR 4 1673 CACTCTGGACCCAAACCA 4~10~4 607 353484 3′UTR 4 1722 CCATTTCAGGAGACCT 3~10~3 608 353506 3′UTR 4 1674 ACTCTGGACCCAAACC 3~10~3 609

Additional oligonucleotides were designed, using the nucleotide sequence of SEQ ID Nos 36 and 205 and incorporating uniformly modified nucleotides. ISIS 353489 and ISIS 353473 (sequences incorporated herein as SEQ ID Nos 36 and 205, respectively) hybridize to target sites 1671 and 1719 of SEQ ID NO: 4, respectively. These two compounds are uniformly comprised of 2′-O-methoxyethyl (2′-MOE) nucleotides, with phosphorothioate internucleoside linkages throughout the oligonucleotide. All cytosines are 5-methylcytosines.

A subset of these antisense oligonucleotides was selected for testing in cytokine-induced Hep3B cells. All oligonucleotides tested share the same nucleotide sequence represented herein as SEQ ID NO: 205, and vary with respect to modifications of the sugar moieties. Cells were cultured and induced as described herein, and subsequently treated with 50, 100 and 200 nM of ISIS 353470, ISIS 353512, ISIS 353472, ISIS 353473 and ISIS 330012 for a period of 24 hours. Cytokine-induced cells served as the control to which data were normalized. C-reactive protein mRNA was measured by real-time PCR as described herein. Data, shown in Table 14, represent the average of 3 experiments and are normalized to data from cells receiving cytokine treatment only. For the gapmers, the configuration of each oligonucleotide is indicated in the same manner as described for Table 13. The oligonucleotide uniformly comprised of 2′-MOE nucleotides is indicated by “uniform 2′-MOE”.

TABLE 14 Comparison of antisense inhibition by oligonucleotides targeted to C-reactive protein having varying 2′-deoxy gaps and varying 2′-MOE wings % mRNA expression relative to cytokine-induced control cells Dose of oligonucleotide ISIS # Configuration 50 nM 100 nM 200 nM 353470 4~12~4 37 28 15 353512 3~14~3 20 16 28 353472 2~16~2 74 42 9 353473 Uniform 2′-MOE 117 89 80 330012 5~10~5 55 39 29

Additional oligonucleotides were designed, using the nucleotide sequence of SEQ ID Nos 36 and 205 and employing differing internucleoside linkages in the compound. ISIS 353514 and ISIS 353515 (sequences incorporated herein as SEQ ID Nos 36 and 205, respectively) hybridize to target sites 1671 and 1719 of SEQ ID NO: 4, respectively. These two compounds are chimeric oligonucleotides, having a 14 nucleotide gap segment composed of 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′) by 3 nucleotide wing segments composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside linkages between nucleotides 2 and 3 and between nucleotides 18 and 19 are phosphodiester. All other nucleoside linkages in the compounds are phosphorthioate. All cytosines are 5-methylcytosines.

Additional olignucleotides were designed using the publicly available sequence of human C-reactive protein (incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 15. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. These compounds are hemimers, or “open end” type compounds, 15 nucleotides in length, wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound and consists of 2′-deoxynucleotides. The remaining segment is composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The exact structure of each oligonucleotide is designated in Table 15 as the “configuration”. A designation of 5˜10, for instance, indicates that a 5 nucleotide segment of a first chemical modification is at the 5′ terminus and a 10 nucleotide segment of a second chemical modification is at the 3′ terminus. A designation of 2′-MOE˜2′-deoxy indicates that the 5′ terminus is comprised of 2′-MOE nucleotides, and the 3′ terminus is comprised of 2′-deoxynucleotides; 2′-MOE nucleotides are further indicated in bold type. Where present, “O” indicates that the internucleoside (backbone) linkages are phosphodiester. All other internucleoside linkages are phosphorothioate (P═S). All cytidine residues are 5-methylcytidines.

TABLE 15 Chimeric hemimers targeted to C-reactive protein TARGET ISIS SEQ ID TARGET SEQ # REGION NO SITE SEQUENCE Configuration ID NO 353698 3′UTR 4 1720 TCCCA _(o)TTTCAGGAGA 5~10 610 2′-MOE~2′-deoxy 353699 3′UTR 4 1719 TTTCAGGAGA_(o) CCTGG 10~5  611 2′-deoxy~2′-MOE 353501 3′UTR 4 1672 GCACTCTGGACCCAA 5~10 612 2′-MOE~2′-deoxy 353504 3′UTR 4 1671 CTGGACCCAAACCAG 1~14 613 2′-deoxy~2′-MOE

Example 33 Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment, oligonucleotides targeted to human C-reactive protein were selected for additional dose-response studies. Following antisense oligonucleotide treatment, C-reactive protein mRNA and secreted protein were measured in primary human hepatocytes, cultured as described herein and cytokine-induced as described herein for Hep3B cells.

Primary human hepatocytes were treated with 12.5, 25, 50, 100 and 200 nM of ISIS 330012 (SEQ ID NO: 205) and ISIS 133726 (SEQ ID NO: 36). Cytokine-induced cells that did not receive oligonucleotide treatment served as controls to which all data were normalized. ISIS 13650 (TCCCGCCTGTGACATGCATT, SEQ ID NO: 614) and ISIS 113529 (SEQ ID NO: 597), neither of which target C-reactive protein, served as control oligonucleotides. Cells were treated with 100 and 200 nM of ISIS 113529 and ISIS 13650. ISIS 13650 is a chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

C-reactive protein mRNA levels were measured after 24 hours of oligonucleotide treatment by real-time PCR as described in other examples herein. Results of these studies are shown in Table 16. Data are averages from three experiments and are expressed as percent mRNA expression relative to data from cytokine-induced cells. Where present, “N.D.” indicates not determined.

TABLE 16 Inhibition of human C-reactive protein mRNA expression in human primary hepatocytes: 24 hr dose response % mRNA expression relative to cytokine- induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 12.5 nM 25 nM 50 nM 100 nM 200 nM 330012 205 42 66 43 45 26 133726  36 53 73 56 36 34 113529 597 N.D. N.D. N.D. 73 97  13650 614 N.D  N.D. N.D. 74 57

As demonstrated in Table 16, doses of 25, 50, 100 and 200 nM of ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 24 hours of oligonucleotide treatment.

In a further embodiment, in the same experiment presented in Table 16, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary human hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 24 hours of oligonucleotide treatment. Data, shown in Table 17, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.

TABLE 17 Inhibition of human C-reactive protein secretion in human primary hepatocytes: 24 hour dose response % Protein secretion relative to cytokine-induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 12.5 nM 25 nM 50 nM 100 nM 200 nM 330012 205 85 67 61 66 65 133726  36 63 67 66 61 68 113529 597 N.D. N.D. N.D. 80 80  13650 614 N.D  N.D. N.D. 79 91

As demonstrated in Table 17, ISIS 330012 inhibited C-reactive protein secretion following 24 hours of oligonucleotide treatment.

In a further embodiment, C-reactive protein mRNA levels in cytokine-induced primary human hepatocytes were measured following 48 hours of oligonucleotide treatment. Cells were treated with 12.5, 25, 50, 100 and 200 nM of ISIS 330012 and ISIS 133726. ISIS 13650 and ISIS 113529 served as control oligonucleotides. Cells were treated with 100 and 200 nM of ISIS 113529 and ISIS 13650. Data, shown in Table 18, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.

TABLE 18 Inhibition of human C-reactive mRNA expression in human primary hepatocytes: 48 hour dose response % mRNA expression relative to cytokine- induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 12.5 nM 25 nM 50 nM 100 nM 200 nM 330012 205 73 53 58  27 19 133726  36 65 53 39  34 19 113529 597 N.D. N.D. N.D. 116 79  13650 598 N.D  N.D. N.D. 116 85

As demonstrated in Table 18, ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 48 hours of oligonucleotide treatment.

In a further embodiment, treatment with ISIS 330012 and ISIS 133726 for 48 hours was repeated, and both C-reactive protein mRNA and protein were measured. C-reactive protein was measured by real-time PCR following 48 hours of oligonucleotide treatment. Data, shown in Table 19, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.

TABLE 19 Inhibition of human C-reactive protein mRNA expression in human primary hepatocytes: 48 hour dose response % mRNA expression relative to cytokine- induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 50 100 200 330012 205 54 36 17 133726 36 72 33 25 113529 597 N.D. N.D. 112

As demonstrated in Table 19, ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 48 hours of oligonucleotide treatment.

In a further embodiment, in the same experiment presented in Table 19, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary human hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 48 hours of oligonucleotide treatment. Data, shown in Table 20, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.

TABLE 20 Inhibition of human C-reactive protein secretion in human primary hepatocytes: 48 hour dose response % Protein secretion relative to cytokine- induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 50 100 200 330012 205 40 25 18 133726 36 37 18 20 113529 597 N.D. N.D. 104

As demonstrated in Table 20, ISIS 330012 and 133726 inhibited C-reactive protein expression in a dose-dependent manner following 48 hours of oligonucleotide treatment. At the 200 nM dose, ISIS 133726 and ISIS 330012 were able to lower C-reactive protein mRNA in cytokine-induced cells to levels below basal expression levels, i.e. levels observed in cells not induced with cytokine. Northern and immunoblot analyses also confirmed the reduction in C-reactive protein mRNA and protein expression after 48 hours of oligonucleotide treatment.

Example 34 Sequencing of Cynomolgus Monkey (Macaca fascicularis) C-Reactive Protein mRNA

In accordance with the present invention, a portion of the cynomolgus monkey C-reactive protein mRNA not available in the art was amplified and sequenced. Positions 537 to 2201 of the human C-reactive protein mRNA sequence (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4) contain the target segment to which ISIS 133726 and ISIS 330012 hybridize. The corresponding segment of Cynomolgus monkey C-reactive protein mRNA was amplified and sequenced, using a series of 8 primer sets designed to the human sequence. Total RNA was purified from Cynomolgus monkey primary hepatocytes (In Vitro Technologies, Gaithersburg, Md.). A reverse transcription was performed to produce cDNA and was followed by approximately 40 rounds of PCR amplification. Following gel purification of the Cynomolgus fragments, the forward and reverse sequencing reactions of each product were performed using the RETROGEN™ kit (Invitrogen). This kit was used to create the single-stranded cDNA and provided reagents for AMPLITAQ™ PCR reaction. The sequenced products were assembled to largely complete the Cynomolgus monkey C-reactive protein mRNA. This Cynomolgus monkey sequence is incorporated herein as SEQ ID NO: 615 and is 93% homologous to positions 537 to 2201 of the human C-reactive protein mRNA. An additional sequence that shares 97% homology with human C-reactive protein from positions 101-290 is incorporated herein as SEQ ID NO: 616.

Example 35 Antisense Inhibition of Cynomolgus Monkey C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies

In a further embodiment, oligonucleotides targeted to human C-reactive protein were selected for additional dose-response studies were tested for their ability to inhibit target mRNA in primary Cynomolgus monkey hepatocytes. Due to the high degree of identity between human and Cynmolgus monkey C-reactive protein, ISIS 133726 (SEQ ID NO: 36) and ISIS 330012 (SEQ ID NO: 205) hybridize to Cynomolgus monkey C-reactive protein with perfect complementarity, at target sites 1147 and 1195 of the Cynomolgus monkey mRNA disclosed herein (SEQ ID NO: 615), respectively. Primary Cynolmolgus monkey hepatocytes were induced with cytokine as described herein for Hep3B cells and were treated with 50, 100 and 200 nM of ISIS 330012 (SEQ ID NO: 205) and ISIS 133726 (SEQ ID NO: 36). ISIS 113529 (SEQ ID NO: 597) served as the control oligonucleotide. Cells were treated with 150 and 300 nM of ISIS 113529.

C-reactive protein mRNA levels were measured following 24 hours of oligonucleotide treatment. Data, shown in Table 21, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.

TABLE 21 Inhibition of Cynomolgus monkey C-reactive protein mRNA expression in human primary hepatocytes: 24 hour dose response % mRNA expression relative to cytokine-induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 25 nM 50 nM 150 nM 300 nM 330012 205  66  62 48 13 133726 36 104 111 47 22 113529 597 N.D. N.D. 130 86

As demonstrated in Table 21, ISIS 330012 (at all doses tested) and ISIS 133726 (at 150 and 300 nM) inhibited C-reactive protein mRNA expression in a dose-dependent manner following 24 hours of oligonucleotide treatment.

In a further embodiment, in the same experiment presented in Table 21, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary Cynomolgus hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 24 hours of oligonucleotide treatment. Data, shown in Table 22, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.

TABLE 22 Inhibition of Cynomolgus monkey C-reactive protein secretion in Cynomolgus monkey primary hepatocytes: 24 hour dose response % protein secretion relative to cytokine induced control cells Dose of oligonucleotide ISIS # SEQ ID NO 50 100 200 330012 205 40 25 18 133726 36 37 18 20 113529 597 N.D. N.D. 104

As demonstrated in Table 22, ISIS 330012 and 133726 inhibited C-reactive protein secretion in a dose-dependent manner following 48 hours of oligonucleotide treatment.

These data demonstrate that ISIS 133726 and ISIS 330012, while designed to target the human C-reactive protein mRNA, are capable of inhibiting both C-reactive protein mRNA and secreted protein in Cynomolgus monkey primary hepatocytes, and are therefore antisense oligonucleotides that can be used to test the inhibition of Cynomolgus monkey C-reactive protein in vivo.

Example 36 Antisense Inhibition of C-Reactive Protein In Vivo: Cynomolgus Monkeys

Cynomolgus monkeys (male or female) are useful to evaluate antisense oligonucleotides for their potential to lower C-reactive protein mRNA or protein levels, as well as phenotypic endpoints associated with C-reactive protein including, but not limited to cardiovascular indicators, atherosclerosis, lipid diseases, obesity, and plaque formation. One study includes normal and induced hypercholesterolemic monkeys fed diets that are normal or high in lipid and cholesterol. Parameters that are observed during the test period include: total plasma cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, arterial wall cholesterol content, and coronary intimal thickening.

In a further embodiment, Cynomolgus monkeys fed an atherogenic diet develop atherosclerosis with many similarities to atherosclerosis of humans and are used to evaluate the potential of antisense compounds to prevent or ameliorate atherosclerosis. Female Cynomolgus macaques share several similarities in lipoproteins and the cardiovascular system with humans. In addition to these characteristics, there are similarities in reproductive biology. The Cynomolgus female has a 28-day menstrual cycle like that of women. Plasma hormone concentrations have been measured throughout the Cynomolgus menstrual cycle, and the duration of the follicular and luteal phases, as well as plasma estradiol and progesterone concentrations across the cycle, are also remarkably similar to those in women.

Antisense oligonucleotides targeted to C-reactive protein are evaluated for efficacy and toxicity in Cynomolgus monkeys. The oligonucleotides chosen for these studies hybridize to two distinct regions of the 3′ UTR of both human and monkey C-reactive protein mRNA. ISIS 133726 (SEQ ID NO: 36) and ISIS 330012 (SEQ ID NO: 205) are chimeric oligonucleotides with a 5˜10˜5 configuration, as described herein. ISIS 353512 (SEQ ID NO: 36) and ISIS 353491 (SEQ ID NO: 205) are the same chimeric oligonucleotides, respectively, with a 3˜14˜3 configuration, as described herein. Cynomolgus monkeys are treated as described in Table 23. Each of the 9 groups presented in Table 23 consists of 5 animals, and the number of males and females in each of these groups is indicated.

TABLE 23 Treatment of Cynomolgus monkeys with oligonucleotides targeted to C-reactive protein: study design Group Number of # Treatment Females/Males Dose mg/kg 1 Saline 3/2 2 ISIS 330012 2/3 7 3 ISIS 330012 3/2 20 4 ISIS 133726 2/3 7 5 ISIS 133726 3/2 20 6 ISIS 353512 2/3 7 7 ISIS 353512 3/2 20 8 ISIS 353491 2/3 7 9 ISIS 353491 3/2 20

All animals are dosed via subcutaneous injection on the study days 1, 3, 5, 8, 11, 15, 18, 22, 25 and 29. The first day of dosing is designated Day 1. The animals are evaluated for changes in general appearance and behavior, food consumption and body weight. Blood samples are collected at 1, 2 and 3 week intervals prior to the start of the study, on days 1 and 29 just prior to dosing and at 1, 2, 4 and 24 hours after dosing and on days 8, 15 and 22 just prior to dosing. Blood samples are subjected to clinical pathology evaluations, which include serum chemistry, hematology, coagulation and urinalysis parameters. Serum chemistry parameters analyzed include sodium, potassium, chloride, carbon dioxide, total bilirubin, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), calcium, phosphorus, blood urea nitrogen (BUN), creatinine, total protein, albumin, globulin, albumin/globulin ratio, glucose, cholesterol and triglycerides. Hematology parameters include red blood cell (RBC) counts, white blood cell (WBC) counts, hemoglobin concentration, hematocrit, reticulocyte counts, plasmodium evaluation, mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), platelet counts and blood cell morphology. Coagulation parameters that are evaluated include activated partial thromboplastin time (APTT) and prothromgin time (PT). Urinalysis parameters that are evaluated include color, character, pH, specific gravity, leukocyte esterase, nitrite, urobilinogen, protein, glucose, ketones, bilirubin, occult blood and microscopics. C-reactive protein in serum is measured using an immunochemiluminescence assay (ICMA). All clinical parameters are measured using routine procedures known in the art. Additionally, a toxicokinetic analysis is performed to determine the concentration of C-reactive protein oligonucleotide in serum. Furthermore, serum levels of cytokines and chemokines, including interleukin-1, interleukin-6, interleukin-8, interferon-gamma, tumor necrosis factor-alpha, monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), macrophage inflammatory protein-1β (MIP-1β), and regulated-on-activation, normal T cell expressed and secreted cytokine (RANTES), are measured to determine the extent of any immune or inflammatory response.

On day 30 of the study, 24 hours after the final dose of saline or oligonucleotide, animals are sacrificed. Final body weights are recorded, and a gross necropsy examination is conducted to evaluate the carcass, muscular/skeletal system, all external surfaces and orifices, cranial cavity and external surface of the brain, neck with associated organs and tissues, thoraci, abdominal and pelvic cavities with associated organs and tissues. Urine is collected from the bladder and analyzed as previously described herein. Kidney, liver, lung, heart and spleen weights are recorded. Cardiovascular, digestive, lymphoid/hematopoietic, urogenital and endocrine tissues are collected and preserved in 10% neutral-buffered formalin. Tissues collected from animals treated with saline and 20 mg/kg oligonucleotide, following preservation in 10% neutral-buffered formalin, are embedded in paraffin, sectioned, stained with hematoxylin and eosin and examined for pathological abnormalities. Bone marrow smears are collected for microscopic examination in cases where bone marrow sections reveal changes or abnormalities. A portion of the liver tissue collected, which has not been preserved in formalin, is homogenized in a buffer that inhibits Rnase activity and is evaluated for C-reactive protein mRNA expression by real-time PCR as described herein. The parameters evaluated in this study determine the efficacy and toxicity of antisense oligonucleotides targeted to C-reactive protein.

Example 37 Antisense Oligonucleotides Targeted to Human C-Reactive Protein In Vivo: Lean Mouse Study

In a further embodiment, antisense oligonucleotides targeted to human C-reactive protein were tested for their effects on serum lipids, serum glucose and indicators of toxicity. Male C57Bl/6 mice (Charles River Laboratories, Wilmington, Mass.) were fed a standard rodent diet. Mice were given intraperitoneal injections of 25 and 50 mg/kg of each of the following antisense oligonucleotides: ISIS 133726 (SEQ ID NO: 36), ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205) and ISIS 330031 (SEQ ID NO: 224). Each oligonucleotide-treated group consisted of 5 mice. A total of 10 saline-injected animals served as controls. Injections were administered twice weekly for a period of 4 weeks. At the end of the treatment period, mice were sacrificed. Body, liver and spleen weights were recorded and exhibited no significant changes.

Serum was collected for routine clinical analysis of ALT, AST, cholesterol (CHOL), glucose (GLUC), HDL-cholesterol (HDL), LDL-cholesterol (LDL), triglycerides (TRIG) and non-esterified free fatty acids (NEFA). These parameters were measured by routine procedures using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). The data are presented in Table 24.

TABLE 24 Serum chemistry analysis of mice treated with antisense oligonucleotides targeted to human C-reactive protein Serum parameters Dose ALT AST CHOL GLUC HDL TG LDL NEFA Treatment mg/kg IU/L IU/L mg/dL mg/dL mg/dL mg/dL mg/dL mEq/L SALINE 45 86 81 187 63 132 14 1.0 133726 25 36 62 85 172 63 158 16 1.2 50 42 64 73 179 54 139 15 1.4 329956 25 31 57 98 172 77 117 17 1.5 50 37 60 105 176 82 149 18 1.7 330012 25 34 71 89 200 71 123 13 1.5 50 35 59 93 187 75 115 12 1.5 330031 25 36 94 80 194 63 131 14 1.5 50 153 443 150 152 83 131 66 1.6

These data reveal that only the 50 mg/kg dose of ISIS 330031 resulted in a significant increase in the liver transaminases ALT and AST, suggesting a hepatotoxic effect at the highest dose of ISIS 330031. Treatment with ISIS 330031 at 50 mg/kg also resulted in an increase in cholesterol and LDL-cholesterol. A moderate increase in cholesterol was observed in animals treated with ISIS 329956 at 50 mg/kg. Increases in non-esterified free fatty acids were observed in mice treated with all oligonucleotides used in this study.

These data reveal that antisense oligonucleotides targeted to human C-reactive protein effectively inhibited target expression in lean mice, without producing overt toxicities.

Example 38 Antisense Inhibition of C-Reactive Protein In Vivo: Rat Study

In a further embodiment, antisense oligonucleotides targeted to C-reactive protein were tested in an additional animal model. Male Sprague Dawley rats (Charles River Laboratories, Wilmington, Mass.), maintained on a standard rodent diet, received intraperitoneal injections of 75 and 100 mg/kg ISIS 197178 (SEQ ID NO: 275) once per week for a period of 6 weeks. Saline-injected animals served as controls. Each treatment group consisted of 5 animals. At the end of the treatment period, the animals were sacrificed and evaluated for C-reactive protein mRNA and protein expression and liver, as well as C-reactive protein expression in serum. mRNA was measured by real-time PCR as described by other examples herein. Protein was measured by ELISA using a commercially available kit (BD Biosciences, Bedford, Mass.). The data, averaged from the 5 animals in each treatment group, are normalized to results from saline-treated animals and are presented in Table 25.

TABLE 25 Effects of antisense inhibition of C-reactive protein in rats % control Dose of ISIS 197178 C-reactive protein: 75 mg/kg 100 mg/kg mRNA 12 13 protein, serum 15 15 protein, liver 32 33

These data demonstrate that ISIS 197178 markedly decreased liver C-reactive protein mRNA and protein, as well as serum protein. Reduction of serum C-reactive protein levels was confirmed by immunoblot analysis using the rat C-reactive protein antibody from the ELISA kit. These results reveal that reduction in liver C-reactive protein mRNA lowers serum C-reactive protein levels, illustrating an important link between liver C-reactive protein production and serum levels.

Example 39 Specificity of Oligonucleotides Targeted to C-Reactive Protein

In a further embodiment, the specificity of ISIS 330012 to C-reactive protein mRNA was investigated. A BLAST search was conducted to determine whether ISIS 330012 could hybridize to genes other than C-reactive protein. This search revealed several genes with sequences that harbor potential binding sites for ISIS 330012. These genes are shown in Table 26, where the number of mismatches is indicated. All potential ISIS 330012 target sites contain 2-3 mismatched nucleotides with respect to ISIS 330012. Also shown are the Unigene ID accession numbers of sequences, both of which are available through the National Center for Biotechnology Information database. The number of times the binding site is repeated in the gene sequence is indicated in the “count” column in Table 26.

TABLE 26 Gene sequences sharing 2-3 mismatches with C-reactive protein at the ISIS 330012 binding site # Mis- GENBANK ® matches Unigene ID Accession # Gene Name Count 2 Hs.256184 NM_001404.1 eukaryotic translation 1 elongation factor 1 gamma 2 Hs.441043 NM_014817.1 importin 11 1 2 Hs.54971 NM_016505.1 putative S1 RNA 1 binding domain protein 3 Hs.11417 NM_006423.1 Rab acceptor 1 3 (prenylated) 3 Hs.121549 NM_145752.1 CDP-diacylglycerol— 1 inositol 3-phosphatidyl- transferase (phosphatidylinositol synthase) 3 Hs.131842 NM_015255.1 ubiquitin ligase E3 2 alpha-II 3 Hs.135226 NM_001908.1 cathepsin B 1 3 Hs.135805 BC016490.1 skeletrophin 1 3 Hs.180577 NM_002087.1 granulin 1 3 Hs.200063 NM_015401.1 histone deacetylase 7A 1 3 Hs.20157 NM_025197.1 CDK5 regulatory 1 subunit associated protein 3 3 Hs.248017 NM_014364.1 glyceraldehyde-3- 1 phosphate dehydrogenase, testis- specific 3 Hs.274268 NM_145648.1 solute carrier family 1 15, member 4 3 Hs.387667 AF106698.1 peroxisome 1 proliferative activated receptor, gamma 3 Hs.418167 NM_000477.3 albumin 2

To test whether ISIS 330012 affects the expression of the genes in Table 26, primary human hepatocytes, cultured as described herein, were treated with 200 nM ISIS 330012 for 48 hours. Expression of the genes in Table 26 was measured by real-time PCR as described herein, using primers and probes designed to publicly available sequences. These data revealed that ISIS 330012 did not modulate the expression of any of the genes in Table 26, illustrating that, in primary hepatocytes, ISIS 330012 specifically hybridizes to, and inhibits, C-reactive protein mRNA.

Example 40 Cell Proliferation and Survival in Response to Cells Treated with Oligomeric Compounds Targeted to C-Reactive Protein

Cell cycle regulation is the basis for various cancer therapeutics. Unregulated cell proliferation is a characteristic of cancer cells, thus most current chemotherapy agents target dividing cells, for example, by blocking the synthesis of new DNA required for cell division. However, cells in healthy tissues are also affected by agents that modulate cell proliferation.

In some cases, a cell cycle inhibitor causes apoptosis in cancer cells, but allows normal cells to undergo growth arrest and therefore remain unaffected (Blagosklonny, Bioessays, 1999, 21, 704-709; Chen et al., Cancer Res., 1997, 57, 2013-2019; Evan and Littlewood, Science, 1998, 281, 1317-1322; Lees and Weinberg, Proc. Natl. Acad. Sci. USA, 1999, 96, 4221-4223). An example of sensitization to anti-cancer agents is observed in cells that have reduced or absent expression of the tumor suppressor genes p53 (Bunz et al., Science, 1998, 282, 1497-1501; Bunz et al., J. Clin. Invest., 1999, 104, 263-269; Stewart et al., Cancer Res., 1999, 59, 3831-3837; Wahl et al., Nat. Med., 1996, 2, 72-79). However, cancer cells often escape apoptosis (Lowe and Lin, Carcinogenesis, 2000, 21, 485-495; Reed, Cancer J. Sci. Am., 1998, 4 Suppl 1, S8-14). Further disruption of cell cycle checkpoints in cancer cells can increase sensitivity to chemotherapy while allowing normal cells to take refuge in G1 and remain unaffected. Cell cycle assays are employed to identify genes, such as p53, whose inhibition sensitizes cells to anti-cancer agents.

Cell Cycle Assay

The effect of oligomeric compounds targeted to C-reactive protein were examined in normal human mammary epithelial cells (HMECs) as well as in two breast carcinoma cell lines, MCF7 and T47D. All of the cell lines are obtained from the American Type Culture Collection (Manassas, Va.). The latter two cell lines express similar genes. MCF7 cells express the tumor suppressor p53, while T47D cells are deficient in p53. MCF-7 and HMECs cells are routinely cultured in DMEM low glucose (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Life Technologies, Carlsbad, Calif.). T47D cells were cultured in DMEM High glucose media (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% fetal bovine serum. Cells were routinely passaged by trypsinization and dilution when they reached approximately 90% confluence. Cells were plated in 24-well plates at approximately 50,000-60,000 cells per well for HMEC cells, approximately 140,000 cells per well for MCF-7 and approximately 170,000 cells per well for T47D cells, and allowed to attach to wells overnight.

ISIS 133726 (SEQ ID NO: 36) was used to test the effects of antisense inhibition of C-reactive protein on cell cycle progression. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) was used a negative control, a compound that does not modulate cell cycle progression. In addition, a positive control for the inhibition of cell proliferation was assayed. The positive control was ISIS 148715 (TTGTCCCAGTCCCAGGCCTC; herein incorporated as SEQ ID NO: 618), which targets human Jagged2 and is known to inhibit cell cycle progression. ISIS 29248 and ISIS 148715 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well containing T47D or MCF7 cells was washed with 150 μl of phosphate-buffered saline. Each well containing HMECs was washed with 150 μL of Hank's balanced salt solution. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. Control cells received LIPOFECTIN™ reagent only. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. After 72 hours, routine procedures were used to prepare cells for flow cytometry analysis and cells were stained with propidium iodide to generate a cell cycle profile using a flow cytometer. The cell cycle profile was analyzed with the ModFit program (Verity Software House, Inc., Topsham Me.).

Fragmentation of nuclear DNA is a hallmark of apoptosis and produces an increase in cells with a hypodiploid DNA content, which are categorized as “subG1”. An increase in cells in G1 phase is indicative of a cell cycle arrest prior to entry into S phase; an increase in cells in S phase is indicative of cell cycle arrest during DNA synthsis; and an increase in cells in the G2/M phase is indicative of cell cycle arrest just prior to or during mitosis. Data are expressed as percentage of cells in each phase relative to the cell cycle profile of untreated control cells and are shown in Table 27.

TABLE 27 Cell cycle profile of cells treated with oligomeric compounds targeted to C-reactive protein G1 S G2/M Treatment Sub G1 Phase Phase Phase HMEC ISIS 133726 135 101 80 111 ISIS 29848 117 99 82 113 ISIS 148715 47 99 88 107 MCF7 ISIS 133726 116 110 83 103 ISIS 29848 130 106 91 98 ISIS 148715 42 109 80 110 T47D ISIS 133726 349 82 111 130 ISIS 29848 154 86 111 118 ISIS 148715 62 83 116 124

These data reveal that ISIS 133726 did not significantly affect cell cycle progression in HMECs, MCF7 cells or T47D cells.

Caspase Assay

Programmed cell death, or apoptosis, is an important aspect of various biological processes, including normal cell turnover, as well as immune system and embryonic development. Apoptosis involves the activation of caspases, a family of intracellular proteases through which a cascade of events leads to the cleavage of a select set of proteins. The caspase family can be divided into two groups: the initiator caspases, such as caspase-8 and -9, and the executioner caspases, such as caspase-3, -6 and -7, which are activated by the initiator caspases. The caspase family contains at least 14 members, with differing substrate preferences (Thornberry and Lazebnik, Science, 1998, 281, 1312-1316). A caspase assay is utilized to identify genes whose inhibition selectively causes apoptosis in breast carcinoma cell lines, without affecting normal cells, and to identify genes whose inhibition results in cell death in the p53-deficient T47D cells, and not in the MCF7 cells which express p53 (Ross et al., Nat. Genet., 2000, 24, 227-235; Scherf et al., Nat. Genet., 2000, 24, 236-244). The chemotherapeutic drugs taxol, cisplatin, etoposide, gemcitabine, camptothecin, aphidicolin and 5-fluorouracil all have been shown to induce apoptosis in a caspase-dependent manner.

In a further embodiment of the invention, oligomeric compounds targeted to C-reactive protein were examined in normal human mammary epithelial cells (HMECs) as well as in two breast carcinoma cell lines, MCF7 and T47D. HMECs and MCF7 cells express p53, whereas T47D cells do not express this tumor suppressor gene. Cells were cultured as described for the cell cycle assay in 96-well plates with black sides and flat, transparent bottoms (Corning Incorporated, Corning, N.Y.). DMEM media, with and without phenol red, were obtained from Invitrogen Life Technologies (Carlsbad, Calif.). MEGM media, with and without phenol red, were obtained from Cambrex Bioscience (Walkersville, Md.).

ISIS 133726 (SEQ ID NO: 36) was used to test the effects of antisense inhibition of C-reactive protein on caspase-activity. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; incorporated herein as SEQ ID NO: 617) was used as a negative control, a compound that does not effect caspase activity. As a positive control for caspase activation, an oligonucleotide targeted to human Jagged2 ISIS 148715 (SEQ ID NO: 618) or human Notchl ISIS 226844 (GCCCTCCATGCTGGCACAGG; herein incorporated as SEQ ID NO: 619) was also assayed. Both of these genes are known to induce caspase activity, and subsequently apoptosis, when inhibited. ISIS 29248, ISIS 148715 and ISIS 226844 are all chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline (150 μL Hank's balanced salt solution for HMEC cells). The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. Compounds targeted to C-reactive protein, ISIS 226844 and ISIS 148715 were tested in triplicate, and ISIS 29848 was tested in up to six replicate wells. Untreated control cells received LIPOFECTIN™ reagent only. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium without phenol red was added to each well.

Caspase-3 activity was evaluated with a fluorometric HTS Caspase-3 assay (Catalog # HTS02; EMD Biosciences, San Diego, Calif.) that detects cleavage after aspartate residues in the peptide sequence (DEVD). The DEVD substrate is labeled with a fluorescent molecule, which exhibits a blue to green shift in fluorescence upon cleavage by caspase-3. Active caspase-3 in the oligonucleotide treated cells is measured by this assay according to the manufacturer's instructions. 48 hours following oligonucleotide treatment, 50 uL of assay buffer containing 10 μM dithiothreitol was added to each well, followed by addition 20 uL of the caspase-3 fluorescent substrate conjugate. Fluorescence in wells was immediately detected (excitation/emission 400/505 nm) using a fluorescent plate reader (SPECTRAMAX™ GEMINIXS™ reader, Molecular Devices, Sunnyvale, Calif.). The plate was covered and incubated at 37° C. for and additional three hours, after which the fluorescence was again measured (excitation/emission 400/505 nm). The value at time zero was subtracted from the measurement obtained at 3 hours. The measurement obtained from the untreated control cells was designated as 100% activity.

The experiment was replicated in each of the 3 cell types, HMECs, T47D and MCF7 and the results are shown in Table 28. From these data, values for caspase activity above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit caspase activity, respectively. The data are shown as percent increase in fluorescence relative to untreated control values.

TABLE 28 Effects of antisense inhibition of C-reactive protein on apoptosis in the caspase assay Percent relative to Cell Type Treatment untreated control HMEC ISIS 133726 148 ISIS 29848 275 ISIS 148715 1006 MCF7 ISIS 133726 77 ISIS 29848 103 ISIS 226844 199 T47D ISIS 133726 125 ISIS 29848 154 ISIS 148715 380

From these data it is evident that inhibition of C-reactive protein expression by ISIS 133726 resulted in an inhibition of apoptosis in MCF7 cells, as compared to untreated control cells controls. These data indicate that this oligomeric compound is a candidate agent with applications in the treatment of conditions in which inhibition of apoptosis is desirable, for example, in neurodegenerative disorders.

Example 41 Assay for Inhibition of Angiogenesis Using Oligomeric Compounds Targeted to C-Reactive Protein

Angiogenesis is the growth of new blood vessels (veins and arteries) by endothelial cells. This process is important in the development of a number of human diseases, and is believed to be particularly important in regulating the growth of solid tumors. Without new vessel formation it is believed that tumors will not grow beyond a few millimeters in size. In addition to their use as anti-cancer agents, inhibitors of angiogenesis have potential for the treatment of diabetic retinopathy, cardiovascular disease, rheumatoid arthritis and psoriasis (Carmeliet and Jain, Nature, 2000, 407, 249-257; Freedman and Isner, J. Mol. Cell. Cardiol., 2001, 33, 379-393; Jackson et al., Faseb J., 1997, 11, 457-465; Saaristo et al., Oncogene, 2000, 19, 6122-6129; Weber and De Bandt, Joint Bone Spine, 2000, 67, 366-383; Yoshida et al., Histol. Histopathol., 1999, 14, 1287-1294).

Endothelial Tube Formation Assay as a Measure of Angiogenesis

Angiogenesis is stimulated by numerous factors that promote interaction of endothelial cells with each other and with extracellular matrix molecules, resulting in the formation of capillary tubes. This morphogenic process is necessary for the delivery of oxygen to nearby tissues and plays an essential role in embryonic development, wound healing, and tumor growth (Carmeliet and Jain, Nature, 2000, 407, 249-257). Moreover, this process can be reproduced in a tissue culture assay that evaluated the formation of tube-like structures by endothelial cells. There are several different variations of the assay that use different matrices, such as collagen I (Kanayasu et al., Lipids, 1991, 26, 271-276), Matrigel (Yamagishi et al., J. Biol. Chem., 1997, 272, 8723-8730) and fibrin (Bach et al., Exp. Cell Res., 1998, 238, 324-334), as growth substrates for the cells. In this assay, HUVECs are plated on a matrix derived from the Engelbreth-Holm-Swarm mouse tumor, which is very similar to Matrigel (Kleinman et al., Biochemistry, 1986, 25, 312-318; Madri and Pratt, J. Histochem. Cytochem., 1986, 34, 85-91). Untreated HUVECs form tube-like structures when grown on this substrate. Loss of tube formation in vitro has been correlated with the inhibition of angiogenesis in vivo (Carmeliet and Jain, Nature, 2000, 407, 249-257; Zhang et al., Cancer Res., 2002, 62, 2034-2042), which supports the use of in vitro tube formation as an endpoint for angiogenesis.

In a further embodiment, primary human umbilical vein endothelial cells (HuVECs) were used to measure the effects of oligomeric compounds targeted to C-reactive protein on tube formation activity. HuVECs were routinely cultured in EBM (Clonetics Corporation, Walkersville, Md.) supplemented with SingleQuots supplements (Clonetics Corporation, Walkersville, Md.). Cells were routinely passaged by trypsinization and dilution when they reached approximately 90% confluence and were maintained for up to 15 passages. HuVECs are plated at approximately 3000 cells/well in 96-well plates. One day later, cells are transfected with antisense oligonucleotides. The tube formation assay is performed using an in vitro Angiogenesis Assay Kit (Chemicon International, Temecula, Calif.).

ISIS 133726 (SEQ ID NO: 36) was used to test the effects of inhibition of C-reactive protein on endothelial tube formation. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, a compound that does not affect tube formation. ISIS 196103 (AGCCCATTGCTGGACATGCA, incorporated herein as SEQ ID NO: 620) which is targeted to integrin-β3 and is known to inhibit endothelial tube formation, was used as a positive control Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to achieve a final concentration of 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. Untreated control cells received LIPOFECTIN™ reagent only. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. ISIS 133726 and ISIS 196103 were tested in triplicate, and ISIS 29848 was tested in up to six replicates. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. Fifty hours after transfection, cells are transferred to 96-well plates coated with ECMa-trix™ (Chemicon Inter-national). Under these conditions, untreated HUVECs form tube-like structures. After an overnight incubation at 37° C., treated and untreated cells are inspected by light microscopy. Individual wells are assigned discrete scores from 1 to 5 depending on the extent of tube formation. A score of 1 refers to a well with no tube formation while a score of 5 is given to wells where all cells are forming an extensive tubular network. Results are expressed as percent tube formation relative to untreated control samples. Treatment with ISIS 133726, ISIS 29848 and ISIS 196103 resulted in 81%, 100% and 51% tube formation, respectively. These results illustrate that ISIS 133726 inhibited tube formation and is thus a candidate agent with applications in the treatment of conditions where the inhibition of angiogenesis is desirable, for example, in the treatment of cancer, diabetic retinopathy, cardiovascular disease, rheumatoid arthritis and psoriasis.

Matrix Metalloproteinase Activity

During angiogenesis, endothelial cells must degrade the extracellular matrix (ECM) and thus secrete matrix metalloproteinases (MMPs) in order to accomplish this degradation. MMPs are a family of zinc-dependent endopeptidases that fall into eight distinct classes: five are secreted and three are membrane-type MMPs (MT-MMPs) (Egeblad and Werb, J. Cell Science, 2002, 2, 161-174). MMPs exert their effects by cleaving a diverse group of substrates, which include not only structural components of the extracellular matrix, but also growth-factor-binding proteins, growth-factor pre-cursors, receptor tyrosine-kinases, cell-adhesion molecules and other proteinases (Xu et al., J. Cell Biol., 2002, 154, 1069-1080).

In a further embodiment, the antisense inhibition of apolipoprotein B was evaluated for effects on MMP activity in the media above human umbilical-vein endothelial cells (HUVECs). MMP activity was measured using the EnzChek Gelatinase/Collagenase Assay Kit (Molecular Probes, Eugene, Oreg.). HUVECs are cultured as described for the tube formation assay. HUVECs are plated at approximately 4000 cells per well in 96-well plates and transfected one day later.

HUVECs were treated with ISIS 133726 (SEQ ID NO: 36) to inhibit C-reactive protein expression. An oligonucleotide with a randomized sequence, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, or a treatment not expected to affect MMP activity. ISIS 25237 (GCCCATTGCTGGACATGC, SEQ ID NO: 621) targets integrin beta 3 and was used as a positive control for the inhibition of MMP activity. ISIS 25237 is a chimeric oligonucleotide (“gapmers”) 18 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by four-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotides. All cytidine residues are 5-methylcytidines.

Cells were treated as described for the tube formation assay, with 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTIN™ reagent. ISIS 133726 and ISIS 25237 were tested in triplicate, and the ISIS 29848 was tested in up to six replicates. The plates were incubated for approximately 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. Approximately 50 hours after transfection, a p-aminophenylmercuric acetate (APMA, Sigma-Aldrich, St. Louis, Mo.) solution is added to each well of a Corning-Costar 96-well clear bottom plate (VWR International, Brisbane, Calif.). The APMA solution is used to promote cleavage of inactive MMP precursor proteins. Media above the HUVECs is then transferred to the wells in the 96-well plate. After 30 minutes, the quenched, fluorogenic MMP cleavage substrate is added, and baseline fluorescence is read immediately at 485 nm excitation/530 nm emission. Following an overnight incubation at 37° C. in the dark, plates are read again to determine the amount of fluorescence, which corresponds to MMP activity. Total protein from HUVEC lysates is used to normalize the readings, and MMP activites are expressed as a percent relative to MMP activity from untreated control cells that did not receive oligonucleotide treatment. MMP activities were 78%, 82% and 58% in the culture media from cells treated with ISIS 133726, ISIS 29848 and ISIS 25237. These data reveal that ISIS 133726 did not inhibit MMP activity.

Example 42 Adipocyte Assay of Oligomeric Compounds Targeted to C-Reactive Protein

Insulin is an essential signaling molecule throughout the body, but its major target organs are the liver, skeletal muscle and adipose tissue. Insulin is the primary modulator of glucose homeostasis and helps maintain a balance of peripheral glucose utilization and hepatic glucose production. The reduced ability of normal circulating concentrations of insulin to maintain glucose homeostasis manifests in insulin resistance which is often associated with diabetes, central obesity, hypertension, polycystic ovarian syndrom, dyslipidemia and atherosclerosis (Saltiel, Cell, 2001, 104, 517-529; Saltiel and Kahn, Nature, 2001, 414, 799-806).

Response of Undifferentiated Adipocytes to Insulin

Insulin promotes the differentiation of preadipocytes into adipocytes. The condition of obesity, which results in increases in fat cell number, occurs even in insulin-resistant states in which glucose transport is impaired due to the antilipolytic effect of insulin. Inhibition of triglyceride breakdown requires much lower insulin concentrations than stimulation of glucose transport, resulting in maintenance or expansion of adipose stores (Kitamura et al., Mol. Cell. Biol., 1999, 19, 6286-6296; Kitamura et al., Mol. Cell. Biol., 1998, 18, 3708-3717).

One of the hallmarks of cellular differentiation is the upregulation of gene expression. During adipocyte differentiation, the gene expression patterns in adipocytes change considerably. Some genes known to be upregulated during adipocyte differentiation include hormone-sensitive lipase (HSL), adipocyte lipid binding protein (aP2), glucose transporter 4 (Glut4), and peroxisome proliferator-activated receptor gamma (PPAR-γ). Insulin signaling is improved by compounds that bind and inactivate PPAR-γ, a key regulator of adipocyte differentiation (Olefsky, J. Clin. Invest., 2000, 106, 467-472). Insulin induces the translocation of GLUT4 to the adipocyte cell surface, where it transports glucose into the cell, an activity necessary for triglyceride synthesis. In all forms of obesity and diabetes, a major factor contributing to the impaired insulin-stimulated glucose transport in adipocytes is the downregulation of GLUT4. Insulin also induces hormone sensitive lipase (HSL), which is the predominant lipase in adipocytes that functions to promote fatty acid synthesis and lipogenesis (Fredrikson et al., J. Biol. Chem., 1981, 256, 6311-6320). Adipocyte fatty acid binding protein (aP2) belongs to a multi-gene family of fatty acid and retinoid transport proteins. aP2 is postulated to serve as a lipid shuttle, solubilizing hydrophobic fatty acids and delivering them to the appropriate metabolic system for utilization (Fu et al., J. Lipid Res., 2000, 41, 2017-2023; Pelton et al., Biochem. Biophys. Res. Commun., 1999, 261, 456-458). Together, these genes play important roles in the uptake of glucose and the metabolism and utilization of fats.

Leptin secretion and an increase in triglyceride content are also well-established markers of adipocyte differentiation. While it serves as a marker for differentiated adipocytes, leptin also regulates glucose homeostasis through mechanisms (autocrine, paracrine, endocrine and neural) independent of the adipocyte's role in energy storage and release. As adipocytes differentiate, insulin increases triglyceride accumulation by both promoting triglyceride synthesis and inhibiting triglyceride breakdown (Spiegelman and Flier, Cell, 2001, 104, 531-543). As triglyceride accumulation correlates tightly with cell size and cell number, it is an excellent indicator of differentiated adipocytes.

The effect of antisense inhibition of C-reactive protein by on the expression of markers of cellular differentiation was examined in preadipocytes. Human white preadipocytes (Zen-Bio Inc., Research Triangle Park, N.C.) were grown in preadipocyte media (ZenBio Inc., Research Triangle Park, N.C.). One day before transfection, 96-well plates were seeded with approximately 3000 cells/well.

A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) was used a negative control, a compound that does not modulate adipocyte differentiation. Tumor necrosis factor-alpha (TNF-α), which inhibits adipocyte differentiation, was used as a positive control for the inhibition of adipocyte differentiation as evaluated by leptin secretion. For all other parameters measured, ISIS 105990 (AGCAAAAGATCAATCCGTTA, incorporated herein as SEQ ID NO: 622), an inhibitor of PPAR-y, served as a positive control for the inhibition of adipocyte differentiation. ISIS 29848 and ISIS 105990 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 250 nM of oligonucleotide and 7.5 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. Untreated control cells received LIPOFECTIN™ reagent only. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. ISIS 133726 and ISIS 105990 were tested in triplicate, ISIS 29848 was tested in up to six replicate wells. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. After the cells have reached confluence (approximately three days), they were exposed for three days to differentiation media (Zen-Bio, Inc.) containing a PPAR-γ agonist, IBMX, dexamethasone, and insulin. Cells were then fed adipocyte media (Zen-Bio, Inc.), which was replaced at 2 to 3 day intervals.

Leptin secretion into the media in which adipocytes are cultured was measured by protein ELISA. On day nine post-transfection, 96-well plates were coated with a monoclonal antibody to human leptin (R&D Systems, Minneapolis, Minn.) and left at 4° C. overnight. The plates were blocked with bovine serum albumin (BSA), and a dilution of the treated adipocyte media was incubated in the plate at room temperature for 2 hours. After washing to remove unbound components, a second monoclonal antibody to human leptin (conjugated with biotin) was added. The plate was then incubated with strepavidin-conjugated horseradish peroxidase (HRP) and enzyme levels were determined by incubation with 3, 3′, 5,5′-tetramethlybenzidine, which turns blue when cleaved by HRP. The OD₄₅₀ was read for each well, where the dye absorbance is proportional to the leptin concentration in the cell lysate. Results, shown in Table 29, are expressed as a percent control relative to untreated control samples. With respect to leptin secretion, values above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit leptin secretion, respectively.

The triglyceride accumulation assay measures the synthesis of triglyceride by adipocytes. Triglyceride accumulation was measured using the Infinity™ Triglyceride reagent kit (Sigma-Aldrich, St. Louis, Mo.). On day nine post-transfection, cells were washed and lysed at room temperature, and the triglyceride assay reagent was added. Triglyceride accumulation was measured based on the amount of glycerol liberated from triglycerides by the enzyme lipoprotein lipase. Liberated glycerol is phosphorylated by glycerol kinase, and hydrogen peroxide is generated during the oxidation of glycerol-1-phosphate to dihydroxyacetone phosphate by glycerol phosphate oxidase. Horseradish peroxidase (HRP) uses H₂O₂ to oxidize 4-aminoantipyrine and 3,5 dichloro-2-hydroxybenzene sulfonate to produce a red-colored dye. Dye absorbance, which is proportional to the concentration of glycerol, was measured at 515 nm using an UV spectrophotometer. Glycerol concentration was calculated from a standard curve for each assay, and data were normalized to total cellular protein as determined by a Bradford assay (Bio-Rad Laboratories, Hercules, Calif.). Results, shown in Table 29, are expressed as a percent control relative to untreated control samples. From these data, values for triglyceride (TRIG) accumulation above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit triglyceride accumulation, respectively.

Expression of the four hallmark genes, HSL, aP2, Glut4, and PPARγ, was also measured in adipocytes transfected with compounds of the invention. Cells were lysed on day nine post-transfection, in a guanadinium-containing buffer and total RNA is harvested. The amount of total RNA in each sample was determined using a Ribogreen Assay (Invitrogen Life Technologies, Carlsbad, Calif.). Real-time PCR was performed on the total RNA using primer/probe sets for the adipocyte differentiation hallmark genes Glut4, HSL, aP2, and PPAR-γ. mRNA levels, shown in Table 29, are expressed as percent control relative to the untreated control values. With respect to the four adipocyte differentiation hallmark genes, values above or below 100% are considered to indicate that the compound has the ability to stimulate adipocyte differentiation, or inhibit it, respectively.

TABLE 29 Effects of antisense inhibition of Tudor-SN on adipocyte differentiation Treatment Leptin TRIG aP2 Glut4 HSL PPARγ ISIS 133726 85 67 93 63 99 77 ISIS 29848 94 76 87 70 87 72 ISIS 105990 N.D. 38 55 53 55 38 TNF-α 27 N.D. N.D. N.D. N.D. N.D.

ISIS 133726 reduced the expression levels leptin, triglycerides and GLUT4, suggesting that this antisense oligonucleotide is a candidate agent for applications where inhibition of adipocytes differentiation is desirable, for example, obesity, hyperlipidemia, atherosclerosis, atherogenesis, diabetes, hypertension, or other metabolic diseases, as well as having potential applications in the maintenance of the pluripotent phenotype of stem or precursor cells.

Example 43 Inflammation Assays Using Oligomeric Compounds Targeted to C-Reactive Protein

Inflammation assays are designed to identify genes that regulate the activation and effector phases of the adaptive immune response. During the activation phase, T lymphocytes (also known as T-cells) receiving signals from the appropriate antigens undergo clonal expansion, secrete cytokines, and upregulate their receptors for soluble growth factors, cytokines and co-stimulatory molecules (Cantrell, Annu. Rev. Immunol., 1996, 14, 259-274). These changes drive T-cell differentiation and effector function. In the effecotr phase, response to cytokines by non-immune effector cells controls the production of inflammatory mediators that can do extensive damage to host tissues. The cells of the adaptive immune systems, their products, as well as their interactions with various enzyme cascades involved in inflammation (e.g., the complement, clotting, fibrinolytic and kinin cascades) represent potential points for intervention in inflammatory disease. The inflammation assay presented here measures hallmarks of the activation phase of the immune response.

Dendritic cells treated with antisense compounds are used to identify regulators of dendritic cell-mediated T-cell costimulation. The level of interleukin-2 (IL-2) production by T-cells, a critical consequence of T-cell activation (DeSilva et al., J. Immunol., 1991, 147, 3261-3267; Salomon and Bluestone, Annu. Rev. Immunol., 2001, 19, 225-252), is used as an endpoint for T-cell activation. T lymphocytes are important immunoregulatory cells that mediate pathological inflammatory responses. Optimal activation of T lymphocytes requires both primary antigen recognition events as well as secondary or costimulatory signals from antigen presenting cells (APC). Dendritic cells are the most efficient APCs known and are principally responsible for antigen presentation to T-cells, expression of high levels of costimulatory molecules during infection and disease, and the induction and maintenance of immunological memory (Banchereau and Steinman, Nature, 1998, 392, 245-252). While a number of costimulatory ligand-receptor pairs have been shown to influence T-cell activation, a principal signal is delivered by engagement of CD28 on T-cells by CD80 (B7-1) and CD86 (B7-2) on APCs (Boussiotis et al., Curr. Opin. Immunol., 1994, 6, 797-807; Lenschow et al., Annu. Rev. Immunol., 1996, 14, 233-258). Inhibition of T-cell co-stimulation by APCs holds promise for novel and more specific strategies of immune suppression. In addition, blocking costimulatory signals may lead to the development of long-term immunological anergy (unresponsiveness or tolerance) that would offer utility for promoting transplantation or dampening autoimmunity. T-cell anergy is the direct consequence of failure of T-cells to produce the growth factor IL-2 (DeSilva et al., J. Immunol., 1991, 147, 3261-3267; Salomon and Bluestone, Annu. Rev. Immunol., 2001, 19, 225-252).

Dendritic Cell Cytokine Production as a Measure of the Activation Phase of the Immune Response

In a further embodiment of the present invention, the effect of ISIS 133726 (SEQ ID NO: 36) was examined on the dendritic cell-mediated costimulation of T-cells. Dendritic cells (DCs, Clonetics Corp., San Diego, Calif.) were plated at approximately 6500 cells/well on anti-CD3 (UCHT1, Pharmingen-BD, San Diego, Calif.) coated 96-well plates in 500 U/mL granulocyte macrophase-colony stimulation factor (GM-CSF) and interleukin-4 (IL-4). DCs were treated with antisense compounds 24 hours after plating.

A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, a compound that does not affect dendritic cell-mediated T-cell costimulation. ISIS 113131 (CGTGTGTCTGTGCTAGTCCC, incorporated herein as SEQ ID NO: 623), an inhibitor of CD86, served as a positive control for the inhibition of dendritic cell-mediated T-cell costimulation. ISIS 29848 and ISIS 113131 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the cells and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. Untreated control cells received LIPOFECTIN™ reagent only. ISIS 133726 and the positive control were tested in triplicate, and the negative control oligonucleotide was tested in up to six replicates. The plates were incubated with oligonucleotide for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. Fresh growth media plus cytokines was added and DC culture was continued for an additional 48 hours. DCs are then co-cultured with Jurkat T-cells in RPMI medium (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% heat-inactivated fetal bovine serum (Sigma Chemical Company, St. Louis, Mo.). Culture supernatants are collected 24 hours later and assayed for IL-2 levels (IL-2 DUOSET™ kit, R&D Systems, Minneapolis, Minn.), which are expressed as a percent relative to untreated control samples. A value greater than 100% indicates an induction of the inflammatory response, whereas a value less than 100% demonstrates a reduction in the inflammatory response.

The culture supernatant of cells treated with ISIS 133726, ISIS 29848 and ISIS 113131 contained IL-2 at 84%, 83% and 55% of the IL-2 concentration found in culture supernatant from untreated control cells, respectively. These results indicate that ISIS 133726 did not inhibit T-cell co-stimulation.

Cytokine Signaling as a Measure of the Effector Phase of the Inflammatory Response

The cytokine signaling assay is designed to identify genes that regulate inflammatory responses of non-immune effector cells (initially endothelial cells) to both IL-1β and TNF-α (Heyninck et al., J Cell Biol, 1999, 145, 1471-1482; Zetoune et al., Cytokine, 2001, 15, 282-298). Response to cytokine stimulation is monitored by tracking the expression levels of four genes: A20, intracellular adhesion molecule 1 (ICAM-1), interleukin-9 (IL-8) and macrophage-inflammatory protein 2 (MIP2α). As described below, these genes regulate numerous parameters of the inflammatory response. Antisense oligonucleotides are used to identify genes that alter the cellular response to these cytokines.

A20 is a zinc-finger protein that limits the transcription of pro-inflammatory genes by blocking TRAF2-stimulated NK-KB signaling. Studies in mice show that TNF-α dramatically increases A20 expression in mice, and that A20 expression is crucial for their survival (Lee et al., Science, 2000, 289, 2350-2354).

ICAM-1 is an adhesion molecule expressed at low levels on resting endothelial cells that is markedly up-regulated in response to inflammatory mediators like tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interferon-γ (IFN-γ) (Springer, Nature, 1990, 346, 425-434). ICAM-1 expression serves to attract circulating leukocytes into the inflammatory site.

IL-8 is a member of the chemokine gene superfamily, members of which promote the pro-inflammatory phenotype of macrophages, vascular smooth muscle cells and endothelial cells (Koch et al., Science, 1992, 258, 1798-1801). IL-8 has been known as one of the major inducible chemokines with the ability to attract neutrophils to the site of inflammation. More recently, IL-8 has been implicated as a major mediator of acute neutrophil-mediated inflammation, and is therefore a potential anti-inflammatory target (Mukaida et al., Cytokine Growth Factor Rev, 1998, 9, 9-23).

MIP2α, another chemokine known to play a central role in leukocyte extravasation, has more recently been shown to be involved in acute inflammation (Lukacs et al., Chem Immunol, 1999, 72, 102-120). MIP2α is expressed in response to microbial infection, to injection of lipopolysaccharides (LPS), and to stimulation of cells with pro-inflammatory mediators such as IL-1β and TNF-α (Kopydlowski et al., J Immunol, 1999, 163, 1537-1544). Endothelial cells are one of several cell types that are sources of MIP2α (Rudner et al., J Immunol, 2000, 164, 6576-6582).

The effect of ISIS 133726 targeted to C-reactive protein was examined in human umbilical vascular endothelial cells (HUVECs) (ATCC, Manassus, Va.). HUVECs are cultured according to the supplier's recommendations. HUVECs are plated in a 96 well plate at a seeding density of approximately 3000 cells per well and are treated with antisense compounds 24 hours later.

A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617), was used as a negative control, a compound that does not affect cytokine signaling. ISIS 29848 is chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.

Oligonucleotide was mixed with LIPOFECTIN™ reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM™ medium (Invitrogen Life Technologies, Carlsbad, Calif.) to achieve a final concentration of 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTIN™ reagent. Before adding to cells, the oligonucleotide, LIPOFECTIN™ reagent and OPTI-MEM™ medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the cells and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEM™ medium/LIPOFECTIN™ reagent cocktail. Untreated control cells received LIPOFECTIN™ reagent only. ISIS 133726 was tested in triplicate, and ISIS 29848 was tested in up to six replicate wells. The plates were incubated with oligonucleotide for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. Fresh growth media plus cytokines was added and DC culture was continued for an additional 46 hours, after which HUVECS were stimulated with 0.1 ng/mL of IL-1β or 1 ng/mL TNF-α for 2 hours. Total RNA is harvested 48 hours post-transfection, and real time PCR is performed using primer/probe sets to detect A20, ICAM-1, IL-8 and MIP2a mRNA expression. Expression levels of each gene, shown in Table 30, are normalized to total RNA and values are expressed as a percent relative to untreated control samples. A value greater than 100% indicates an induction of the inflammatory response, whereas a value less than 100% demonstrates a reduction in the inflammatory response.

TABLE 30 Effects of antisense inhibition of C-reactive protein on the inflammatory response +IL-1β +TNF α Treatment A20 ICAM-1 IL-8 MIP2α IL-8 MIP2α ISIS 133726 95 64 77 58 130 77 ISIS 29848 101 89 96 86 84 71

ISIS 133726 inhibited the expression of ICAM-1, IL-8 and MIP2α in response to IL-1β stimulation, and therefore is a candidate agent for the treatment of conditions in which inhibition or reduction of the inflammatory response is desirable, for example, in conditions such as rheumatoid arthritis, asthma and inflammatory bowel diseases. Conversely, ISIS 133726 stimulated the response of IL-8 in the presence of TNF-α, suggesting that in this stimulatory pathway, inhibition of C-reactive protein can stimulate an immune response, and is a candidate agent for the treatment of conditions in which stimulation of the immune response is desirable, for example, in conditions characterized by immunodeficiency.

Example 44 Antisense Oligonucleotides Targeted to Mouse C-Reactive Protein In Vivo: Lean Mouse Study

In a further embodiment, antisense oligonucleotides targeted to mouse C-reactive protein were tested for their effects on target expression, serum lipids, serum glucose and indicators of toxicity. Male C57Bl/6 mice (Charles River Laboratories, Wilmington, Mass.) were fed a standard rodent diet. Mice were given intraperitoneal injections of 50 mg/kg of each of ISIS 147868 (SEQ ID NO: 580) and ISIS 147880 (SEQ ID NO: 592). Each oligonucleotide-treated group consisted of 5 mice. A total of 5 saline-injected animals served as controls. Injections were administered twice weekly for a period of 2 weeks. At the end of the treatment period, mice were sacrificed. No significant changes were observed in body weights, which were recorded weekly, nor in liver and spleen weights recorded at necropsy.

C-reactive protein mRNA expression in liver was measured by real-time PCR, as described by other examples herein. ISIS 147868 and ISIS 147880, at a 50 mg/kg dose, resulted in 48% and 5% reductions in mouse C-reactive protein mRNA, respectively.

Serum was collected for routine clinical analysis of ALT, AST, cholesterol (CHOL), glucose (GLUC), HDL-cholesterol (HDL), LDL-cholesterol (LDL) and triglycerides (TRIG). These parameters were measured by routine procedures using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). The data are presented in Table 31.

TABLE 31 Serum chemistry analysis of mice treated with antisense oligonucleotides targeted to mouse C-reactive protein Serum parameters Dose HDL LDL TG GLUC mg/ ALT AST CHOL mg/ mg/ mg/ mg/ Treatment kg IU/L IU/L mg/dL dL dL dL dL SALINE 27 62 80 61 11 102 243 147868 50 25 56 82 61 12 113 214 147880 50 43 72 96 73 13 125 228

These data reveal that treatment with ISIS 147868 or ISIS 147880 did not result in changes in the serum parameters measured. Together, these results illustrate that ISIS 147868 reduced C-reactive protein mRNA expression in vivo without causing toxicity. ISIS 147880 did not cause toxicity in mice. 

1. An antisense compound 15 to 30 nucleobases in length targeted to a nucleic acid molecule encoding C-reactive protein, wherein said compound comprises a 15 nucleobase portion having at least 90% complementarity to at least a 15 nucleobase portion of nucleotides 1719 to 1738 of SEQ ID NO.
 4. 2. The antisense compound of claim 1, wherein said antisense compound has a nucleobase sequence that is at least 95% complementary to at least a 15 nucleobase portion of nucleotides 1719-1738 of SEQ ID NO:
 4. 3. The antisense compound of claim 1, wherein said antisense compound has a nucleobase sequence that is 100% complementary to at least a 15 nucleobase portion of nucleotides 1719-1738 of SEQ ID NO:
 4. 4. The antisense compound of claim 1, wherein said antisense compound comprises an antisense oligonucleotide.
 5. The antisense compound of claim 4, wherein said antisense compound comprises a chimeric oligonucleotide.
 6. The antisense compound of claim 1, wherein said antisense compound comprises at least one modified internucleoside linkage, modified sugar moiety, or modified nucleobase.
 7. The antisense compound of claim 1, wherein said antisense compound comprises at least one 2′-O-methoxyethyl sugar moiety.
 8. The antisense compound of claim 1, wherein said antisense compound comprises at least one phosphorothioate internucleoside linkage.
 9. The antisense compound of claim 1, wherein said antisense compound comprises at least one 5-methylcytosine.
 10. The antisense compound of claim 5, wherein said chimeric oligonucleotide comprises a 2′-deoxynucleotide segment positioned between wing segments, each wing segment having two to five nucleotides comprising modified sugar moieties, wherein each internucleoside linkage of said chimeric oligonucleotide is a phosphorothioate internucleoside linkage and wherein all cytidine residues are 5-methylcytidines.
 11. The antisense compound of claim 1, wherein said antisense compound is single-stranded.
 12. An antisense compound 20 nucleobases in length targeted to a nucleic acid molecule encoding C-reactive protein, comprising: at least 16 consecutive nucleotides of SEQ ID NO: 205; a 5′ terminus having two to four 2′-O-methoxyethyl nucleotides; a 3′ terminus having two to four 2′-O-methoxyethyl nucleotides; and a 2′-deoxynucleotide portion twelve to sixteen nucleotides in length disposed between said 5′ terminus and said 3′ terminus.
 13. The antisense compound of claim 12, wherein all internucleoside linkages are phosphorothioate.
 14. The antisense compound of claim 12, wherein all cytidine residues are 5-methylcytidines.
 15. The antisense compound of claim 12, wherein each terminus is two nucleotides in length and said 2′-deoxynucleotide portion is sixteen nucleobases in length.
 16. The antisense compound of claim 12, wherein each terminus is three nucleotides in length and said 2′-deoxynucleotide portion is fourteen nucleobases in length.
 17. The antisense compound of claim 12, wherein each terminus is four nucleotides in length and said 2′-deoxynucleotide portion is twelve nucleobases in length.
 18. The antisense compound of claim 12, wherein said antisense compound has a nucleobase sequence consisting of SEQ ID NO:
 205. 19. A method of treating an animal having a disease or condition treatable by reducing C-reactive protein comprising administering to said animal a therapeutically or prophylactically effective amount of the compound of claim 1 so that expression of C-reactive protein is inhibited.
 20. The method of claim 19, wherein said disease or condition is selected from the group consisting of: coronary artery disease, unstable angina, stroke, atherosclerosis, myocardial infarction, thrombosis, obesity, metabolic syndrome, diabetes, hyperlipidemia, acute coronary syndrome, and coronary artery stenting.
 21. The method according to claim 19 wherein said animal is a human.
 22. The method according to claim 19, wherein said disease or condition is selected from the group consisting of: coronary artery disease, unstable angina, atherosclerosis, myocardial infarction, hyperlipidemia, and coronary artery stenting.
 23. The method according to claim 19, wherein said disease or condition is coronary artery disease.
 24. The method according to claim 19, wherein said disease or condition is unstable angina.
 25. The method according to claim 19, wherein said disease or condition is atherosclerosis.
 26. The method according to claim 19, wherein said disease or condition is myocardial infarction.
 27. The method according to claim 19, wherein said disease or condition is hyperlipidemia.
 28. The method according to claim 19, wherein said disease or condition is coronary artery stenting.
 29. The method according to claim 19, wherein said disease or condition is stroke.
 30. The method according to claim 19, wherein said disease or condition is thrombosis.
 31. The method according to claim 19, wherein said disease or condition is obesity.
 32. The method according to claim 19, wherein said disease or condition is metabolic syndrome.
 33. The method according to claim 19, wherein said disease or condition is diabetes.
 34. The method according to claim 19, wherein said disease or condition is acute coronary syndrome.
 35. The antisense compound of claim 1, wherein said antisense compound comprises at least one bicyclic nucleic acid sugar moiety.
 36. The antisense compound of claim 12, wherein said antisense compound comprises an antisense oligonucleotide.
 37. An antisense oligonucleotide consisting the nucleobase sequence of SEQ ID NO: 205, having a 2′-deoxynucleotide portion fourteen nucleotides in length positioned between a 5′ terminus and a 3′ terminus, wherein said 5′ terminus has three 2′-O-methoxyethylnucleotides, wherein said 3′terminus has three 2′-O-methoxyethylnucleotides, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage, and wherein each cytosine is a 5-methylcytosine.
 38. The antisense oligonucleotide of claim 37, wherein the antisense oligonucleotide is in a pharmaceutically acceptable salt form.
 39. A composition comprising the antisense oligonucleotide of claim 38 and a pharmaceutically acceptable carrier or excipient.
 40. The antisense oligonucleotide of claim 38, wherein the salt is a sodium salt.
 41. The method of claim 19 wherein said antisense oligonucleotide consists of the nucleobase sequence of SEQ ID NO: 205, having a 2′-deoxynucleotide portion fourteen nucleotides in length positioned between a 5′ terminus and a 3′ terminus, wherein said 5′ terminus has three 2′-O-methoxyethylnucleotides, wherein said 3′ terminus has three 2′-O-methoxyethylnucleotides, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage, and wherein each cytosine is a 5-methylcytosine.
 42. The method of claim 41 wherein said antisense oligonucleotide is in a pharmaceutically acceptable salt form. 